05D2296405 CLIA NUMBER - CORONA CONGREGATE

Laboratory Demographics

  • CLIA Code: 05D2296405
  • Facility Name: CORONA CONGREGATE
  • Facility Address: 7890 VANDERWATER ST
    EASTVALE, CA
    ZIP 92880
  • Facility Phone: 951 415-1120
  • Facility Type: Other - CONGREGATE LIVING HLTH
  • Facility Type: Waiver
  • Lab Director: PETER MATAR
  • NPI Number: 1467197103
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2296405
LAB Type Other - CONGREGATE LIVING HLTH
Facility Name CORONA CONGREGATE
Street 7890 VANDERWATER ST
City EASTVALE
State CA
ZIP 92880
Phone 951 415-1120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Other - CONGREGATE LIVING HLTH
Lab Director PETER MATAR

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