05D2149121 CLIA NUMBER - BENCHMARK TRANSITIONS AT WILDWOOD CANYON

Laboratory Demographics

  • CLIA Code: 05D2149121
  • Facility Name: BENCHMARK TRANSITIONS AT WILDWOOD CANYON
  • Facility Address: 6442 WILDWOOD CANYON ROAD
    YUCAIPA, CA
    ZIP 92399
  • Facility Phone: 800 474-4848
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: COURTNY S. SCOTT
  • NPI Number: 1881186245
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 05D2149121
LAB Type Ancillary Testing Site in Health Care Center
Facility Name BENCHMARK TRANSITIONS AT WILDWOOD CANYON
Street 6442 WILDWOOD CANYON ROAD
City YUCAIPA
State CA
ZIP 92399
Phone 800 474-4848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director COURTNY S. SCOTT

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