05D2197096 CLIA NUMBER - JDMD CLINICS, APC

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Laboratory Demographics

CLIA Number: 05D2197096

Facility Name: JDMD CLINICS, APC

Facility Address:
3333 CONCOURS STREET SUITE 4200
ONTARIO, CA
ZIP 91764
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Facility Phone Number: 909 287-7230

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124640776

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D2197096
LAB Type	Physician Office
Facility Name	JDMD CLINICS, APC
Street	3333 CONCOURS STREET SUITE 4200
City	ONTARIO
State	CA
ZIP	91764
Phone	909 287-7230
CertificateType	4
CertificateEffectiveDate	10/21/2022
CertificateExpirationDate	10/20/2024
FacilityType	Waiver

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