05D2306972 CLIA NUMBER - SAC HEALTH SYSTEM MURRIETA #430

Laboratory Demographics

  • CLIA Code: 05D2306972
  • Facility Name: SAC HEALTH SYSTEM MURRIETA #430
  • Facility Address: 28078 BAXTER RD., STE 430
    MURRIETA, CA
    ZIP 92563
  • Facility Phone: 909 382-7100
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: BONNIE CHI-LUM
  • NPI Number: 1649547944
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2306972
LAB Type Federally Qualified Health Center
Facility Name SAC HEALTH SYSTEM MURRIETA #430
Street 28078 BAXTER RD., STE 430
City MURRIETA
State CA
ZIP 92563
Phone 909 382-7100
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Federally Qualified Health Center
Lab Director BONNIE CHI-LUM

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