05D2084680 CLIA NUMBER - SIERRA PACIFIC PEDIATRIC ASSOCIATES - EASTVALE

Laboratory Demographics

  • CLIA Code: 05D2084680
  • Facility Name: SIERRA PACIFIC PEDIATRIC ASSOCIATES - EASTVALE
  • Facility Address: 12442 LIMONITE AVE STE A202
    MIRA LOMA, CA
    ZIP 91752
  • Facility Phone: 909 829-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD C. CHANG, MD
  • NPI Number: 1457544454
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2084680
LAB Type Physician Office
Facility Name SIERRA PACIFIC PEDIATRIC ASSOCIATES - EASTVALE
Street 12442 LIMONITE AVE STE A202
City MIRA LOMA
State CA
ZIP 91752
Phone 909 829-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Physician Office
Lab Director RICHARD C. CHANG, MD

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