05D0925790 CLIA NUMBER - MAGNOLIA CLINICA MEDICA FAMILIAR

Laboratory Demographics

  • CLIA Code: 05D0925790
  • Facility Name: MAGNOLIA CLINICA MEDICA FAMILIAR
  • Facility Address: 9939 MAGNOLIA AVE
    RIVERSIDE, CA
    ZIP 92503
  • Facility Phone: 951 687-8802
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAVIER R. RIOS MD
  • NPI Number: 1770246779
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0925790
LAB Type Physician Office
Facility Name MAGNOLIA CLINICA MEDICA FAMILIAR
Street 9939 MAGNOLIA AVE
City RIVERSIDE
State CA
ZIP 92503
Phone 951 687-8802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director JAVIER R. RIOS MD

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This page was last updated on: 9/29/2025