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05D2121503 CLIA NUMBER - MAGNOLIA WOMEN MEDICAL CENTER

Laboratory Demographics

CLIA Number: 05D2121503

Facility Name: MAGNOLIA WOMEN MEDICAL CENTER

Facility Address:
4500 BROCKTON AVE, STE 315
RIVERSIDE, CA
ZIP 92501
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Facility Phone Number: 951 681-7133

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1578947404

Taxonomy: 2086S0127X - Surgery
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.

CLIA Record

Field Name Field Value
CLIA Number 05D2121503
LAB Type Physician Office
Facility Name MAGNOLIA WOMEN MEDICAL CENTER
Street 4500 BROCKTON AVE, STE 315
City RIVERSIDE
State CA
ZIP 92501
Phone 951 681-7133
CertificateType 4
CertificateEffectiveDate 11/7/2022
CertificateExpirationDate 11/6/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024