05D2008080 CLIA NUMBER - TIFFANY ANDERSON TERRELL DO

Laboratory Demographics

  • CLIA Code: 05D2008080
  • Facility Name: TIFFANY ANDERSON TERRELL DO
  • Facility Address: 5450 JEFFERSON AVE, STE 1
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 219-9804
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIFFANY ANDERSON TERRELL
  • NPI Number: 1629188404
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2008080
LAB Type Physician Office
Facility Name TIFFANY ANDERSON TERRELL DO
Street 5450 JEFFERSON AVE, STE 1
City CHINO
State CA
ZIP 91710
Phone 909 219-9804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director TIFFANY ANDERSON TERRELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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