05D0963284 CLIA NUMBER - TRI VALLEY UROLOGY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0963284
  • Facility Name: TRI VALLEY UROLOGY MEDICAL GROUP
  • Facility Address: 25495 MEDICAL CENTER DR STE 204
    MURRIETA, CA
    ZIP 92562
  • Facility Phone: 951 698-1901
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: SHANG-TIAN CHUANG DO
  • NPI Number: 1427309749
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D0963284
LAB Type Independent
Facility Name TRI VALLEY UROLOGY MEDICAL GROUP
Street 25495 MEDICAL CENTER DR STE 204
City MURRIETA
State CA
ZIP 92562
Phone 951 698-1901
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/11/2021
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director SHANG-TIAN CHUANG DO

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