05D2047469 CLIA NUMBER - AMERICAN SPINE

Laboratory Demographics

  • CLIA Code: 05D2047469
  • Facility Name: AMERICAN SPINE
  • Facility Address: 1810 FULLERTON AVENUE, SUITE 104
    CORONA, CA
    ZIP 92881
  • Facility Phone: 951 734-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHURAM A. SIAL
  • NPI Number: 1235511833
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2047469
LAB Type Physician Office
Facility Name AMERICAN SPINE
Street 1810 FULLERTON AVENUE, SUITE 104
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 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Physician Office
Lab Director KHURAM A. SIAL

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