05D0555419 CLIA NUMBER - BVCV OPERATING COMPANY DBA COUNTRY VILLA MONTE VISTA HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0555419
  • Facility Name: BVCV OPERATING COMPANY DBA COUNTRY VILLA MONTE VISTA HEALTHCARE CENTER
  • Facility Address: 802 BUENA VISTA STREET
    DUARTE, CA
    ZIP 91010
  • Facility Phone: 626 359-8141
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ZAW MIN MD
  • NPI Number: 1376538256
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0555419
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BVCV OPERATING COMPANY DBA COUNTRY VILLA MONTE VISTA HEALTHCARE CENTER
Street 802 BUENA VISTA STREET
City DUARTE
State CA
ZIP 91010
Phone 626 359-8141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ZAW MIN MD

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