05D0930542 CLIA NUMBER - ROSALIE A DE GUZMAN MD INC

Laboratory Demographics

  • CLIA Code: 05D0930542
  • Facility Name: ROSALIE A DE GUZMAN MD INC
  • Facility Address: 823 SOUTH MAIN STREET SUITE 100
    CORONA, CA
    ZIP 92882
  • Facility Phone: 951 270-0067
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSALIE A. DE GUZMAN MD
  • NPI Number: 1386675452
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0930542
LAB Type Physician Office
Facility Name ROSALIE A DE GUZMAN MD INC
Street 823 SOUTH MAIN STREET SUITE 100
City CORONA
State CA
ZIP 92882
Phone 951 270-0067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Physician Office
Lab Director ROSALIE A. DE GUZMAN MD

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