Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EVERSIDE HEALTH-VICTORVILLE
NPI 1063193852
Clinic/Center in Victorville, CA

Q: What is Everside Health-Victorville's NPI number?

The NPI number for Everside Health-Victorville is 1063193852. It was assigned to this organization in the NPPES registry on July 26, 2023.

Q: What is Everside Health-Victorville's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since July 26, 2023CLIA 31D2270637 · Waiver

15632 BEAR VALLEY RD STE 104, VICTORVILLE, CA 92395(704) 661-1380 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 17, 2026, Jul 26, 2023 (2 updates tracked since 2023).

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About Everside Health-victorville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERSIDE HEALTH-VICTORVILLE (NPI 1063193852) is a healthcare organization registered as a clinic/center in Victorville, California and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through October 18, 2026 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1063193852

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameEVERSIDE HEALTH-VICTORVILLE

Location Address15632 BEAR VALLEY RD STE 104Victorville, CA 92395-8518

Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916

Phone(704) 661-1380

Organization SubpartNo

Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546

Enumeration DateJuly 26, 2023

Last NPPES UpdateSeptember 17, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2026

✔ NPI 1063193852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

15632 BEAR VALLEY RD STE 104, Victorville, CA 92395

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2270637

Everside Health LLC - Willingboro · Willingboro, NJ

Active · expires Oct 18, 2026

CLIA Number31D2270637

Laboratory TypePhysician Office

Certificate Effective DateOctober 19, 2024

Certificate Expiration DateOctober 18, 2026

Laboratory DirectorJanine Beckles

Laboratory Phone(704) 661-1380

Laboratory LocationEverside Health LLC - Willingboro630 Beverly-Rancocas Road, Willingboro, NJ 08046

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Everside Health-Victorville's NPI number?

The NPI number for Everside Health-Victorville is 1063193852. It was assigned to this organization in the NPPES registry on July 26, 2023.

Where is Everside Health-Victorville located?

Everside Health-Victorville is located at 15632 Bear Valley Rd Ste 104, Victorville, CA 92395. The listed phone number is (704) 661-1380.

What is Everside Health-Victorville's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Everside Health-Victorville hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2270637) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Everside Health-Victorville was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.