05D0995275 CLIA NUMBER - JIN M KIM FAMILY MD INC

Laboratory Demographics

  • CLIA Code: 05D0995275
  • Facility Name: JIN M KIM FAMILY MD INC
  • Facility Address: 8237 ROCHESTER AVE STE 130
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 948-7590
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JIN M. KIM, MD
  • NPI Number: 1558371401
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0995275
LAB Type Physician Office
Facility Name JIN M KIM FAMILY MD INC
Street 8237 ROCHESTER AVE STE 130
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 948-7590
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director JIN M. KIM, MD

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This page was last updated on: 6/4/2025