05D2035406 CLIA NUMBER - EGB HOLDINGS DBA ADVANTAGE HEALTH SYSTEMS

Laboratory Demographics

  • CLIA Code: 05D2035406
  • Facility Name: EGB HOLDINGS DBA ADVANTAGE HEALTH SYSTEMS
  • Facility Address: 4100 LATHAM ST STE D
    RIVERSIDE, CA
    ZIP 92501
  • Facility Phone: 951 686-0003
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANQUSHEH ASHOURI MD
  • NPI Number: 1558658864
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2035406
LAB Type Home Health Agency
Facility Name EGB HOLDINGS DBA ADVANTAGE HEALTH SYSTEMS
Street 4100 LATHAM ST STE D
City RIVERSIDE
State CA
ZIP 92501
Phone 951 686-0003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Home Health Agency
Lab Director ANQUSHEH ASHOURI MD

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