05D1087354 CLIA NUMBER - RIVERSIDE MEDICAL CLINIC INC

Laboratory Demographics

CLIA Number: 05D1087354

Facility Name: RIVERSIDE MEDICAL CLINIC INC

Facility Address:
21634 RETREAT PARKWAY
CORONA, CA
ZIP 92883
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Facility Phone Number: 951 321-6307

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Microscopy

NPI Number: 1013561810

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D1087354
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	RIVERSIDE MEDICAL CLINIC INC
Street	21634 RETREAT PARKWAY
City	CORONA
State	CA
ZIP	92883
Phone	951 321-6307
CertificateType	3
CertificateEffectiveDate	8/1/2022
CertificateExpirationDate	7/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024