05D2090561 CLIA NUMBER - OPTIMA HEALTH - CRESTLINE

Laboratory Demographics

  • CLIA Code: 05D2090561
  • Facility Name: OPTIMA HEALTH - CRESTLINE
  • Facility Address: 580 FOREST SHADE RD #1
    CRESTLINE, CA
    ZIP 92325
  • Facility Phone: 909 338-1851
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRO SHAROBIEM
  • NPI Number: 1033167119
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2090561
LAB Type Physician Office
Facility Name OPTIMA HEALTH - CRESTLINE
Street 580 FOREST SHADE RD #1
City CRESTLINE
State CA
ZIP 92325
Phone 909 338-1851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director ANDRO SHAROBIEM

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