05D2161546 CLIA NUMBER - CENTRAL OCCUPATIONAL MEDICINE PROVIDERS

Laboratory Demographics

CLIA Number: 05D2161546

Facility Name: CENTRAL OCCUPATIONAL MEDICINE PROVIDERS

Facility Address:
59 SOUTH MILLIKEN AVENUE, SUITE 100
ONTARIO, CA
ZIP 91761
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Facility Phone Number: (909) 605-8888

Facility Type: INDUSTRIAL

Certificate Type: Waiver

NPI Number: 1669730321

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2161546
LAB Type	INDUSTRIAL
Facility Name	CENTRAL OCCUPATIONAL MEDICINE PROVIDERS
Street	59 SOUTH MILLIKEN AVENUE, SUITE 100
City	ONTARIO
State	CA
ZIP	91761
Phone	(909) 605-8888

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This page was last updated on: 5/11/2023