05D1029813 CLIA NUMBER - ONTARIO OUTPATIENT

Laboratory Demographics

  • CLIA Code: 05D1029813
  • Facility Name: ONTARIO OUTPATIENT
  • Facility Address: 812 N EUCLID AVE
    ONTARIO, CA
    ZIP 91762
  • Facility Phone: 310 314-6200
  • Facility Type: Other - SUBSTANCE USE OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: JONATHAN QUACH
  • NPI Number: 1063878510
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1029813
LAB Type Other - SUBSTANCE USE OUTPATIENT
Facility Name ONTARIO OUTPATIENT
Street 812 N EUCLID AVE
City ONTARIO
State CA
ZIP 91762
Phone 310 314-6200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Other - SUBSTANCE USE OUTPATIENT
Lab Director JONATHAN QUACH

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