05D1060440 CLIA NUMBER - CAREFIRST MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D1060440
  • Facility Name: CAREFIRST MEDICAL GROUP INC
  • Facility Address: 3550 EAST PHILADELPHIA ST STE 150
    ONTARIO, CA
    ZIP 91761
  • Facility Phone: 909 773-0022
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TEODORO G. DIAZ III
  • NPI Number: 1548356884
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1060440
LAB Type Physician Office
Facility Name CAREFIRST MEDICAL GROUP INC
Street 3550 EAST PHILADELPHIA ST STE 150
City ONTARIO
State CA
ZIP 91761
Phone 909 773-0022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director TEODORO G. DIAZ III

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