05D0965017 CLIA NUMBER - RUPAL B SHAH MD INC

Laboratory Demographics

  • CLIA Code: 05D0965017
  • Facility Name: RUPAL B SHAH MD INC
  • Facility Address: 770 MAGNOLIA AVENUE, SUITE 1-K
    CORONA, CA
    ZIP 92879
  • Facility Phone: 951 738-0303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUPAL B. SHAH MD
  • NPI Number: 1396730560
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0965017
LAB Type Physician Office
Facility Name RUPAL B SHAH MD INC
Street 770 MAGNOLIA AVENUE, SUITE 1-K
City CORONA
State CA
ZIP 92879
Phone 951 738-0303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Physician Office
Lab Director RUPAL B. SHAH MD

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