05D2296236 CLIA NUMBER - EVERSIDE HEALTH - VICTORVILLE

Laboratory Demographics

  • CLIA Code: 05D2296236
  • Facility Name: EVERSIDE HEALTH - VICTORVILLE
  • Facility Address: 15632 BEAR VALLEY ROAD
    VICTORVILLE, CA
    ZIP 92395
  • Facility Phone: 704 936-5536
  • Facility Type: Other - CHRONIC MGT
  • Facility Type: Waiver
  • Lab Director: JOHN LANDSBERG
  • NPI Number: 1063193852
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2296236
LAB Type Other - CHRONIC MGT
Facility Name EVERSIDE HEALTH - VICTORVILLE
Street 15632 BEAR VALLEY ROAD
City VICTORVILLE
State CA
ZIP 92395
Phone 704 936-5536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Other - CHRONIC MGT
Lab Director JOHN LANDSBERG

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