05D0935375 CLIA NUMBER - ERIC L SHEPARD MD

Laboratory Demographics

  • CLIA Code: 05D0935375
  • Facility Name: ERIC L SHEPARD MD
  • Facility Address: 4244 RIVERWALK PKWY, SUITE 240
    RIVERSIDE, CA
    ZIP 92505
  • Facility Phone: 951 734-2900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC L. SHEPARD
  • NPI Number: 1558443614
  • Taxonomy: 208800000X - Urology

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director ERIC L. SHEPARD

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