05D2121510 CLIA NUMBER - MAGNOLIA WOMEN MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D2121510
  • Facility Name: MAGNOLIA WOMEN MEDICAL CENTER
  • Facility Address: 3975 JACKSON ST STE 110
    RIVERSIDE, CA
    ZIP 92503
  • Facility Phone: 951 351-1071
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HESHAM EL MOKADEM
  • NPI Number: 1912905191
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D2121510
LAB Type Physician Office
Facility Name MAGNOLIA WOMEN MEDICAL CENTER
Street 3975 JACKSON ST STE 110
City RIVERSIDE
State CA
ZIP 92503
Phone 951 351-1071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director HESHAM EL MOKADEM

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