05D2210769 CLIA NUMBER - KENNETH GRIER MD INC

Laboratory Demographics

  • CLIA Code: 05D2210769
  • Facility Name: KENNETH GRIER MD INC
  • Facility Address: 18564 US HIGHWAY 18, SUITE 101
    APPLE VALLEY, CA
    ZIP 92307
  • Facility Phone: 760 475-9080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH GRIER
  • NPI Number: 1972109551
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2210769
LAB Type Physician Office
Facility Name KENNETH GRIER MD INC
Street 18564 US HIGHWAY 18, SUITE 101
City APPLE VALLEY
State CA
ZIP 92307
Phone 760 475-9080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director KENNETH GRIER

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