05D0927306 CLIA NUMBER - HAMPTON MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 05D0927306

Facility Name: HAMPTON MEDICAL CLINIC

Facility Address:
2671 IOWA AVE
RIVERSIDE, CA
ZIP 92507
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Facility Phone Number: 909 784-0444

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962608356

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0927306
LAB Type	Physician Office
Facility Name	HAMPTON MEDICAL CLINIC
Street	2671 IOWA AVE
City	RIVERSIDE
State	CA
ZIP	92507
Phone	909 784-0444
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024