05D2113663 CLIA NUMBER - ADELANTO WEST DETENTION FACILITY

Laboratory Demographics

  • CLIA Code: 05D2113663
  • Facility Name: ADELANTO WEST DETENTION FACILITY
  • Facility Address: 10250 RANCHO RD
    ADELANTO, CA
    ZIP 92301
  • Facility Phone: 615 312-7226
  • Facility Type: Other - JAIL
  • Facility Type: Waiver
  • Lab Director: RICHARD M. MEDRANO, MD
  • NPI Number: 1164952545
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2113663
LAB Type Other - JAIL
Facility Name ADELANTO WEST DETENTION FACILITY
Street 10250 RANCHO RD
City ADELANTO
State CA
ZIP 92301
Phone 615 312-7226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Other - JAIL
Lab Director RICHARD M. MEDRANO, MD

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