05D1065044 CLIA NUMBER - BEAVER MEDICAL GROUP L P BANNING PRIMARY CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D1065044
  • Facility Name: BEAVER MEDICAL GROUP L P BANNING PRIMARY CARE CENTER
  • Facility Address: 5957 W RAMSEY ST
    BANNING, CA
    ZIP 92220
  • Facility Phone: 909 786-0844
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: JILL R. CUNI
  • NPI Number: 1619914959
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1065044
LAB Type Community Clinic
Facility Name BEAVER MEDICAL GROUP L P BANNING PRIMARY CARE CENTER
Street 5957 W RAMSEY ST
City BANNING
State CA
ZIP 92220
Phone 909 786-0844
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Community Clinic
Lab Director JILL R. CUNI

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