05D2006096 CLIA NUMBER - GARY L BAKER MD, A PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2006096
  • Facility Name: GARY L BAKER MD, A PROFESSIONAL CORPORATION
  • Facility Address: 9041 MAGNOLIA AVE STE 303
    RIVERSIDE, CA
    ZIP 92503
  • Facility Phone: 562 408-4636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY L. BAKER
  • NPI Number: 1437167863
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2006096
LAB Type Physician Office
Facility Name GARY L BAKER MD, A PROFESSIONAL CORPORATION
Street 9041 MAGNOLIA AVE STE 303
City RIVERSIDE
State CA
ZIP 92503
Phone 562 408-4636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2024
Certificate Expiration Date 12/4/2026
Facility Type Physician Office
Lab Director GARY L. BAKER

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