05D2263863 CLIA NUMBER - PALM DESERT VA CBOC

Laboratory Demographics

  • CLIA Code: 05D2263863
  • Facility Name: PALM DESERT VA CBOC
  • Facility Address: 72700 DINAH SHORE DR.
    PALM DESERT, CA
    ZIP 92211
  • Facility Phone: 716 830-8087
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: RAYMOND WONG
  • NPI Number: 1164581997
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 05D2263863
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PALM DESERT VA CBOC
Street 72700 DINAH SHORE DR.
City PALM DESERT
State CA
ZIP 92211
Phone 716 830-8087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director RAYMOND WONG

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