05D2131168 CLIA NUMBER - MEDICROSS CLINIC & URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2131168
  • Facility Name: MEDICROSS CLINIC & URGENT CARE
  • Facility Address: 487 MAGNOLIA AVE STE 102
    CORONA, CA
    ZIP 92879
  • Facility Phone: 951 272-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE N. CHIDI
  • NPI Number: 1760862650
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2131168
LAB Type Physician Office
Facility Name MEDICROSS CLINIC & URGENT CARE
Street 487 MAGNOLIA AVE STE 102
City CORONA
State CA
ZIP 92879
Phone 951 272-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Physician Office
Lab Director GEORGE N. CHIDI

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