05D2001988 CLIA NUMBER - GROVE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 05D2001988
  • Facility Name: GROVE INTERNAL MEDICINE
  • Facility Address: 8283 GROVE AVENUE, SUITE 201
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 981-6644
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SEAN TO
  • NPI Number: 1811224298
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2001988
LAB Type Physician Office
Facility Name GROVE INTERNAL MEDICINE
Street 8283 GROVE AVENUE, SUITE 201
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 981-6644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Physician Office
Lab Director SEAN TO

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