05D2078273 CLIA NUMBER - BANNING FAMILY COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 05D2078273
  • Facility Name: BANNING FAMILY COMMUNITY HEALTH CENTER
  • Facility Address: 1070 E RAMSEY ST
    BANNING, CA
    ZIP 92220
  • Facility Phone: 909 708-8158
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DONALD A. UNDERWOOD
  • NPI Number: 1881717957
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2078273
LAB Type Federally Qualified Health Center
Facility Name BANNING FAMILY COMMUNITY HEALTH CENTER
Street 1070 E RAMSEY ST
City BANNING
State CA
ZIP 92220
Phone 909 708-8158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Federally Qualified Health Center
Lab Director DONALD A. UNDERWOOD

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