05D2180704 CLIA NUMBER - POMONA URGENT CARE

Laboratory Demographics

CLIA Number: 05D2180704

Facility Name: POMONA URGENT CARE

Facility Address:
1749 N GAREY AVE
POMONA, CA
ZIP 91767
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Facility Phone Number: 909 729-5079

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790324481

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2180704
LAB Type	Physician Office
Facility Name	POMONA URGENT CARE
Street	1749 N GAREY AVE
City	POMONA
State	CA
ZIP	91767
Phone	909 729-5079
CertificateType	4
CertificateEffectiveDate	9/7/2022
CertificateExpirationDate	9/6/2024
FacilityType	Waiver

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