05D0942988 CLIA NUMBER - INLAND PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 05D0942988
  • Facility Name: INLAND PRIMARY CARE, INC
  • Facility Address: 1910 ORANGE TREE LANE, STE 320
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 909 793-2363
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM ANGKADJAJA
  • NPI Number: 1881202661
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0942988
LAB Type Physician Office
Facility Name INLAND PRIMARY CARE, INC
Street 1910 ORANGE TREE LANE, STE 320
City REDLANDS
State CA
ZIP 92374
Phone 909 793-2363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director WILLIAM ANGKADJAJA

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