05D2275665 CLIA NUMBER - WHITESIDE MANOR

Laboratory Demographics

  • CLIA Code: 05D2275665
  • Facility Name: WHITESIDE MANOR
  • Facility Address: 2743 ORANGE STREET
    RIVERSIDE, CA
    ZIP 92501
  • Facility Phone: 951 788-9515
  • Facility Type: Other - RESIDENTIAIL TREATMENT
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. VALDEZ
  • NPI Number: 1467902502
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2275665
LAB Type Other - RESIDENTIAIL TREATMENT
Facility Name WHITESIDE MANOR
Street 2743 ORANGE STREET
City RIVERSIDE
State CA
ZIP 92501
Phone 951 788-9515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - RESIDENTIAIL TREATMENT
Lab Director MICHAEL S. VALDEZ

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This page was last updated on: 3/20/2025