05D0929913 CLIA NUMBER - BEAVER MEDICAL GROUP YUCAIPA LP

Laboratory Demographics

  • CLIA Code: 05D0929913
  • Facility Name: BEAVER MEDICAL GROUP YUCAIPA LP
  • Facility Address: 33758 YUCAIPA BLVD
    YUCAIPA, CA
    ZIP 92399
  • Facility Phone: 909 786-0844
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: MEHDI S. JAHROMI MD
  • NPI Number: 1205013323
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0929913
LAB Type Community Clinic
Facility Name BEAVER MEDICAL GROUP YUCAIPA LP
Street 33758 YUCAIPA BLVD
City YUCAIPA
State CA
ZIP 92399
Phone 909 786-0844
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Community Clinic
Lab Director MEHDI S. JAHROMI MD

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