05D2028096 CLIA NUMBER - RIVERSIDE LIFE SERVICES

Laboratory Demographics

  • CLIA Code: 05D2028096
  • Facility Name: RIVERSIDE LIFE SERVICES
  • Facility Address: 3727 MCCRAY ST
    RIVERSIDE, CA
    ZIP 92506
  • Facility Phone: 951 784-2422
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: THOMAS F. MINAHAN
  • NPI Number: 1114288586
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2028096
LAB Type Community Clinic
Facility Name RIVERSIDE LIFE SERVICES
Street 3727 MCCRAY ST
City RIVERSIDE
State CA
ZIP 92506
Phone 951 784-2422
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Community Clinic
Lab Director THOMAS F. MINAHAN

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