05D0716080 CLIA NUMBER - GLENDORA GRAND, INC

Laboratory Demographics

  • CLIA Code: 05D0716080
  • Facility Name: GLENDORA GRAND, INC
  • Facility Address: 805 WEST ARROW HIGHWAY
    GLENDORA, CA
    ZIP 91740
  • Facility Phone: 626 331-0781
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PRAKESH PATEL
  • NPI Number: 1497077739
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0716080
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GLENDORA GRAND, INC
Street 805 WEST ARROW HIGHWAY
City GLENDORA
State CA
ZIP 91740
Phone 626 331-0781
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 PRAKESH PATEL

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