05D0935375 CLIA NUMBER - ERIC L SHEPARD MD

Laboratory Demographics

CLIA Number: 05D0935375

Facility Name: ERIC L SHEPARD MD

Facility Address:
4244 RIVERWALK PKWY, SUITE 240
RIVERSIDE, CA
ZIP 92505
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Facility Phone Number: 951 734-2900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558443614

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	05D0935375
LAB Type	Physician Office
Facility Name	ERIC L SHEPARD MD
Street	4244 RIVERWALK PKWY, SUITE 240
City	RIVERSIDE
State	CA
ZIP	92505
Phone	951 734-2900
CertificateType	4
CertificateEffectiveDate	10/28/2023
CertificateExpirationDate	10/27/2025
FacilityType	Waiver

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