05D2113708 CLIA NUMBER - BALDY VIEW HEALTHCARE

Laboratory Demographics

  • CLIA Code: 05D2113708
  • Facility Name: BALDY VIEW HEALTHCARE
  • Facility Address: 1780 TOWN AND COUNTRY DR STE 103
    NORCO, CA
    ZIP 92860
  • Facility Phone: 951 270-0757
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMON FAKHOURY, MD
  • NPI Number: 1912132754
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2113708
LAB Type Physician Office
Facility Name BALDY VIEW HEALTHCARE
Street 1780 TOWN AND COUNTRY DR STE 103
City NORCO
State CA
ZIP 92860
Phone 951 270-0757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2024
Certificate Expiration Date 5/26/2026
Facility Type Physician Office
Lab Director RAMON FAKHOURY, MD

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