05D2126182 CLIA NUMBER - CENTRO MEDICO DEL CARMEN

Laboratory Demographics

  • CLIA Code: 05D2126182
  • Facility Name: CENTRO MEDICO DEL CARMEN
  • Facility Address: 13373 PERRIS BLVD STE C202A
    MORENO VALLEY, CA
    ZIP 92553
  • Facility Phone: 951 242-8155
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS L. WATSON
  • NPI Number: 1821532508
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D2126182
LAB Type Physician Office
Facility Name CENTRO MEDICO DEL CARMEN
Street 13373 PERRIS BLVD STE C202A
City MORENO VALLEY
State CA
ZIP 92553
Phone 951 242-8155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Physician Office
Lab Director THOMAS L. WATSON

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