NPIMap

Organization Active NPI

County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
National Provider Identifier
1952496010
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1158 PUBLIC HEALTH Issued in CA
Legal business name
COUNTY OF RIVERSIDE
Practice address
4065 County Circle Dr
Riverside, CA 92503-3410
Phone
(951) 358-5070
Fax
(951) 358-5015
NPI assigned
Oct 4, 2006
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Geoffrey Won-Chen Leung, MD
Title
Public Health Officer
Phone
(951) 358-5070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1158 PUBLIC HEALTH CA Primary

Addresses

Primary practice location

4065 County Circle Dr
Riverside, CA 92503-3410

Mailing address

PO Box 7600
Riverside, CA 92513-7600
Phone (951) 358-5070

Other identifiers 2

IdentifierTypeStateIssuer
05D0571882OtherCACLIA #
LAB71882FMedicaidCA

Other names 1

  • Public Health Laboratory Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240812000811 CA Part B Supplier - Independent Clinical Laboratory 6507754488 Practice locations: Riverside, CA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0571882County of Riverside Doph Laboratory4065 County Circle Dr, Ste 106, Riverside, CA 92503ComplianceJul 31, 2026
05D0898853County of Riverside4065 County Circle Dr #304, Riverside, CA 92503Provider-performed microscopyMar 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Riverside Neighborhood244 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations (25 of 32)

49500 Twin Pines Rd
Banning, CA 92220
Phone (951) 600-6801

68615 Perez Rd
Ste 6A
Cathedral City, CA 92234
Phone (760) 770-2222

68625 Perez Rd
Ste 11A
Cathedral Cty, CA 92234
Phone (760) 773-6760

629 N Main St
Ste C3
Corona, CA 92878
Phone (951) 254-7730

46900 Monroe St
Ste 101A
Indio, CA 92201
Phone (760) 863-7219

47923 Oasis St
Rm 1CL
Indio, CA 92201
Phone (760) 863-8283

2499 E Lakeshore Dr
#B
Lake Elsinore, CA 92530
Phone (951) 471-4200

31760 Casino Dr
Lake Elsinore, CA 92530
Phone (951) 471-4600

23119 Cottonwood Ave
Moreno Valley, CA 92553
Phone (951) 413-5130

26600 Cactus Ave
Fl 1
Moreno Valley, CA 92555

3111 E Tahquitz Canyon Way
Palm Springs, CA 92262
Phone (760) 778-2210

1688 N Perris Blvd
Ste L11
Perris, CA 92571
Phone (951) 443-2200

237 N D St
Perris, CA 92570
Phone (951) 940-6700

10186 Indiana Ave
Riverside, CA 92503
Phone (951) 509-2400

1020 Iowa Ave
Ste B
Riverside, CA 92507
Phone (951) 358-4493

10230 Indiana Ave
Riverside, CA 92503
Phone (951) 358-6234

1695 Spruce St
Riverside, CA 92507
Phone (909) 358-4705

1827 Atlanta Ave
Ste D2
Riverside, CA 92507
Phone (951) 955-0840

3125 Myers St
Riverside, CA 92503
Phone (951) 358-4840

3625 14th St
Riverside, CA 92501
Phone (951) 955-1540

3833 10th St
Riverside, CA 92501
Phone (951) 328-2283

3840 Myers St
Riverside, CA 92503
Phone (951) 358-4850

4065 County Circle Dr
Riverside, CA 92503
Phone (951) 358-5311

4065 County Circle Dr
Rm 412
Riverside, CA 92503
Phone (909) 358-4487

4065 County Circle Dr
Ste 106
Riverside, CA 92503
Phone (951) 358-5070

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Riverside University Health Systems - Medical CenterMoreno Valley, CA, CCN 050292 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 31, 1998
County of RiversideJurupa Valley, CA, CCN 051059 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 2, 2006
County of RiversideHemet, CA, CCN 551829 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideRiverside, CA, CCN 551827 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2013
County of RiversidePerris, CA, CCN 551825 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideBanning, CA, CCN 551830 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideCorona, CA, CCN 551824 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversidePalm Springs, CA, CCN 551828 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideLake Elsinore, CA, CCN 551831 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideIndio, CA, CCN 551826 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
Rubidoux Family Care CenterRiverside, CA, CCN 751056 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2014
Mar 1, 2014
Moreno Valley Community Health CenterMoreno Valley, CA, CCN 921147 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 6, 2018
Aug 6, 2018
County of RiversidePerris, CA, CCN 921193 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 27, 2019
Jun 27, 2016
Main Campus Community Health CenterMoreno Valley, CA, CCN 921865 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 16, 2020
Mar 16, 2020
Main Campus First Floor CHCMoreno Valley, CA, CCN A01872 Federally qualified health center Operational/Managerial Control Jan 15, 2024

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Practitioners & affiliated clinicians

Practitioners 429

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 429

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1952496010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7600",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137600",
            "telephone_number": "951-358-5070",
            "fax_number": "951-358-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4065 COUNTY CIRCLE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033410",
            "telephone_number": "951-358-5070",
            "fax_number": "951-358-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RIVERSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "WON-CHEN",
        "authorized_official_title_or_position": "PUBLIC HEALTH OFFICER",
        "authorized_official_telephone_number": "951-358-5070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "1158 PUBLIC HEALTH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "05D0571882",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB71882F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Public Health Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Public Health Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.