05D2092666 CLIA NUMBER - CHAPARRAL MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 05D2092666
  • Facility Name: CHAPARRAL MEDICAL GROUP, INC
  • Facility Address: 9170 HAVEN AVENUE SUITE 120
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 467-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EWA H. KONCA, MD
  • NPI Number: 1376940221
  • Taxonomy: 207RE0101X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2092666
LAB Type Physician Office
Facility Name CHAPARRAL MEDICAL GROUP, INC
Street 9170 HAVEN AVENUE SUITE 120
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 467-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Physician Office
Lab Director EWA H. KONCA, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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