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MT. SAN ANTONIO COLLEGE
NPI 1962687269
Clinic/Center - Student Health in Walnut, CA

Active since January 04, 2008CLIA 05D0867498 · Microscopy
1100 N GRAND AVE, 67B, WALNUT, CA 91789(909) 594-5611(909) 468-3997 Get Directions Write a Review

NPPES record last updated: January 4, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mt. San Antonio College NPPES

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

MT. SAN ANTONIO COLLEGE (NPI 1962687269) is a healthcare organization registered as a student health in Walnut, California and active in the NPI registry since January 2008. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Sandra Samples, Director, Student Health Services, as its authorized official.

NPPES Registry Identity

NPI1962687269
Entity TypeOrganization
Primary Taxonomy261QS1000X
Legal Business NameMT. SAN ANTONIO COLLEGE
Location Address1100 N GRAND AVE, 67BWalnut, CA 91789-1341
Mailing Address1100 N Grand Ave, 67bWalnut, CA 91789-1341 · (909) 591-5611 · Fax (909) 468-3997
Phone(909) 594-5611
Fax(909) 468-3997
Organization SubpartNo
Authorized OfficialSandra SamplesDirector, Student Health Services · (909) 594-5611
Enumeration DateJanuary 4, 2008
✔ NPI 1962687269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Student HealthAmbulatory Health Care Facilities
Taxonomy Code261QS1000X
1100 N GRAND AVE, Walnut, CA 91789
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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 for Provider-Performed Microscopy Procedures (PPMP) 05D0867498

Mt San Antonio Community College · Walnut, CA
Active · expires Aug 31, 2026
CLIA Number05D0867498
Laboratory TypeSchool/Student Health Service
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKatty H. Chou
Laboratory Phone(909) 274-4400
Laboratory LocationMt San Antonio Community College1100 N Grand Ave, Walnut, CA 91789
CLIA data matches this NPI record on: Address
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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELVA SALCIDO
Specialist/Technologist (Athletic Trainer)
1100 N GRAND AVE
WALNUT, CA 91789
Los Angeles County (909) 274-7500
ALEXANDRIA ALICIA LACAYO MS, ATC
Specialist/Technologist (Athletic Trainer)
1100 N GRAND AVE
WALNUT, CA 91789
Los Angeles County (925) 628-7628
KEVIN MARK ATC, EMT-B
Specialist/Technologist (Athletic Trainer)
1100 N GRAND AVE
WALNUT, CA 91789
Los Angeles County (909) 274-6555
ANDREW PAULIN ATC
Specialist/Technologist (Athletic Trainer)
1100 N GRAND AVE
WALNUT, CA 91789
Los Angeles County (909) 594-5611
MRS. MONICA LILIANA GROVE ATC
Specialist/Technologist (Athletic Trainer)
1100 N GRAND AVE
WALNUT, CA 91789
Los Angeles County (909) 594-5611
ANN GRAVES WALKER MD
Internal Medicine
1100 N GRAND AVE, BLDG. 67B
WALNUT, CA 91789
Los Angeles County (909) 594-5611

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 Mt. San Antonio College's NPI number?

The NPI number for Mt. San Antonio College is 1962687269. It was assigned to this organization in the NPPES registry on January 4, 2008.

Where is Mt. San Antonio College located?

Mt. San Antonio College is located at 1100 N Grand Ave 67B, Walnut, CA 91789. The listed phone number is (909) 594-5611.

What is Mt. San Antonio College's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Student Health, with taxonomy code 261QS1000X.

Does Mt. San Antonio College hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0867498) is associated with this NPI, valid through August 31, 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 Mt. San Antonio College was last updated on January 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.