05D2136280 CLIA NUMBER - PEDIATRIC CARDIOLOGY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 05D2136280
  • Facility Name: PEDIATRIC CARDIOLOGY SPECIALISTS
  • Facility Address: 350 E VANERBILT AVENUE
    SAN BERNARDINO, CA
    ZIP 92408
  • Facility Phone: 909 886-5200
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD KANAKRIYEH
  • NPI Number: 1356541429
  • Taxonomy: 2080P0202X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2136280
LAB Type Practitioner Other
Facility Name PEDIATRIC CARDIOLOGY SPECIALISTS
Street 350 E VANERBILT AVENUE
City SAN BERNARDINO
State CA
ZIP 92408
Phone 909 886-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Practitioner Other
Lab Director MOHAMMAD KANAKRIYEH

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