05D2176825 CLIA NUMBER - SAN BERNARDINO COMMUNITY URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2176825
  • Facility Name: SAN BERNARDINO COMMUNITY URGENT CARE
  • Facility Address: 103 EAST HIGHLAND AVE
    SAN BERNARDINO, CA
    ZIP 92404
  • Facility Phone: 909 748-6569
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: WALTER JONES III
  • NPI Number: 1912475914
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2176825
LAB Type Practitioner Other
Facility Name SAN BERNARDINO COMMUNITY URGENT CARE
Street 103 EAST HIGHLAND AVE
City SAN BERNARDINO
State CA
ZIP 92404
Phone 909 748-6569
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/26/2023
Certificate Expiration Date 12/25/2025
Facility Type Practitioner Other
Lab Director WALTER JONES III

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