05D1048054 CLIA NUMBER - INLAND VALLEY HOME HEALTH AGENCY

Laboratory Demographics

  • CLIA Code: 05D1048054
  • Facility Name: INLAND VALLEY HOME HEALTH AGENCY
  • Facility Address: 5050 PALO VERDE ST STE 209
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 626-8221
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MICHAEL CHAI
  • NPI Number: 1033301270
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1048054
LAB Type Home Health Agency
Facility Name INLAND VALLEY HOME HEALTH AGENCY
Street 5050 PALO VERDE ST STE 209
City MONTCLAIR
State CA
ZIP 91763
Phone 909 626-8221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Home Health Agency
Lab Director MICHAEL CHAI

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