05D2296911 CLIA NUMBER - RIVERSIDE PRIMARY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 05D2296911
  • Facility Name: RIVERSIDE PRIMARY CARE CLINIC
  • Facility Address: 3988 MERRILL AVE
    RIVERSIDE, CA
    ZIP 92506
  • Facility Phone: 818 370-6581
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOANNA AYALA
  • NPI Number: 1316010499
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D2296911
LAB Type Physician Office
Facility Name RIVERSIDE PRIMARY CARE CLINIC
Street 3988 MERRILL AVE
City RIVERSIDE
State CA
ZIP 92506
Phone 818 370-6581
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Physician Office
Lab Director JOANNA AYALA

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