05D2065861 CLIA NUMBER - PREMIUM CARE CLINIC

Laboratory Demographics

  • CLIA Code: 05D2065861
  • Facility Name: PREMIUM CARE CLINIC
  • Facility Address: 11882 DE PALMA RD, STE 2F1
    CORONA, CA
    ZIP 92883
  • Facility Phone: 951 603-3335
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHALED M. EL-SAID
  • NPI Number: 1386923019
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2065861
LAB Type Physician Office
Facility Name PREMIUM CARE CLINIC
Street 11882 DE PALMA RD, STE 2F1
City CORONA
State CA
ZIP 92883
Phone 951 603-3335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Physician Office
Lab Director KHALED M. EL-SAID

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