05D2046285 CLIA NUMBER - CORONA SPECIALTY CARE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2046285
  • Facility Name: CORONA SPECIALTY CARE SURGERY CENTER
  • Facility Address: 1810 FULLERTON AVE., SUITE 103
    CORONA, CA
    ZIP 92881
  • Facility Phone: 951 734-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHURAM SIAL
  • NPI Number: 1760740674
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2046285
LAB Type Physician Office
Facility Name CORONA SPECIALTY CARE SURGERY CENTER
Street 1810 FULLERTON AVE., SUITE 103
City CORONA
State CA
ZIP 92881
Phone 951 734-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director KHURAM SIAL

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