05D0608654 CLIA NUMBER - A GRACE SUB ACUTE & SKILLED CARE

Laboratory Demographics

  • CLIA Code: 05D0608654
  • Facility Name: A GRACE SUB ACUTE & SKILLED CARE
  • Facility Address: 1250 S WINCHESTER BLVD
    SAN JOSE, CA
    ZIP 95128
  • Facility Phone: 408 241-3844
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TSUNG CHANG CHEN MD
  • NPI Number: 1962648626
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0608654
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name A GRACE SUB ACUTE & SKILLED CARE
Street 1250 S WINCHESTER BLVD
City SAN JOSE
State CA
ZIP 95128
Phone 408 241-3844
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 TSUNG CHANG CHEN MD

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