05D2075605 CLIA NUMBER - MEAD VALLEY CLINICA MEDICA FAMILIAR

Laboratory Demographics

  • CLIA Code: 05D2075605
  • Facility Name: MEAD VALLEY CLINICA MEDICA FAMILIAR
  • Facility Address: 21091 RIDER ST STE 218
    PERRIS, CA
    ZIP 92570
  • Facility Phone: 951 940-5511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAVIER R. RIOS
  • NPI Number: 1881021434
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2075605
LAB Type Physician Office
Facility Name MEAD VALLEY CLINICA MEDICA FAMILIAR
Street 21091 RIDER ST STE 218
City PERRIS
State CA
ZIP 92570
Phone 951 940-5511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director JAVIER R. RIOS

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