05D2250000 CLIA NUMBER - SHAHIDA'S PLACE

Laboratory Demographics

  • CLIA Code: 05D2250000
  • Facility Name: SHAHIDA'S PLACE
  • Facility Address: 19660 ARCADIA ST
    CORONA, CA
    ZIP 92881
  • Facility Phone: 909 367-6818
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAHROUTZ GHODSIAN
  • NPI Number: 1467048579
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2250000
LAB Type Physician Office
Facility Name SHAHIDA'S PLACE
Street 19660 ARCADIA ST
City CORONA
State CA
ZIP 92881
Phone 909 367-6818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Physician Office
Lab Director SHAHROUTZ GHODSIAN

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