05D2144093 CLIA NUMBER - POMONA COMMUNITY HEALTH CENTER DBA PARKTREE COMMUNITY HEALTH

Laboratory Demographics

CLIA Number: 05D2144093

Facility Name: POMONA COMMUNITY HEALTH CENTER DBA PARKTREE COMMUNITY HEALTH

Facility Address:
2680 E. RIVERSIDE DR.
ONTARIO, CA
ZIP 91761
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Facility Phone Number: 909 469-9013

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1154788560

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2144093
LAB Type	Federally Qualified Health Center
Facility Name	POMONA COMMUNITY HEALTH CENTER DBA PARKTREE COMMUNITY HEALTH
Street	2680 E. RIVERSIDE DR.
City	ONTARIO
State	CA
ZIP	91761
Phone	909 469-9013
CertificateType	3
CertificateEffectiveDate	2/10/2024
CertificateExpirationDate	2/9/2026
FacilityType	PPMP

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