05D1032721 CLIA NUMBER - RIVERSIDE FAMILY PHYSICIANS A PROF MED CORP

Laboratory Demographics

  • CLIA Code: 05D1032721
  • Facility Name: RIVERSIDE FAMILY PHYSICIANS A PROF MED CORP
  • Facility Address: 4244 RIVERWALK PARKWAY STE 150
    RIVERSIDE, CA
    ZIP 92505
  • Facility Phone: 951 781-6335
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAREK Z. MAHDI MD
  • NPI Number: 1407163942
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 05D1032721
LAB Type Physician Office
Facility Name RIVERSIDE FAMILY PHYSICIANS A PROF MED CORP
Street 4244 RIVERWALK PARKWAY STE 150
City RIVERSIDE
State CA
ZIP 92505
Phone 951 781-6335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2023
Certificate Expiration Date 10/5/2025
Facility Type Physician Office
Lab Director TAREK Z. MAHDI MD

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