05D1078443 CLIA NUMBER - LAS PALMAS MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D1078443
  • Facility Name: LAS PALMAS MEDICAL CLINIC
  • Facility Address: 527 N PALM AVE STE 106
    ONTARIO, CA
    ZIP 91762
  • Facility Phone: 909 391-3423
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRMA LOPEZ MD
  • NPI Number: 1013214568
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D1078443
LAB Type Physician Office
Facility Name LAS PALMAS MEDICAL CLINIC
Street 527 N PALM AVE STE 106
City ONTARIO
State CA
ZIP 91762
Phone 909 391-3423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Physician Office
Lab Director IRMA LOPEZ MD

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