05D1071903 CLIA NUMBER - RAYMOND J ESPARZA MD INC

Laboratory Demographics

  • CLIA Code: 05D1071903
  • Facility Name: RAYMOND J ESPARZA MD INC
  • Facility Address: 1330 W COVINA BLVD SUITE 203
    SAN DIMAS, CA
    ZIP 91773
  • Facility Phone: 909 394-0044
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAYMOND J. ESPARAZA
  • NPI Number: 1497717391
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1071903
LAB Type Physician Office
Facility Name RAYMOND J ESPARZA MD INC
Street 1330 W COVINA BLVD SUITE 203
City SAN DIMAS
State CA
ZIP 91773
Phone 909 394-0044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director RAYMOND J. ESPARAZA

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