05D0719592 CLIA NUMBER - EVERGREEN CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0719592
  • Facility Name: EVERGREEN CARE CENTER
  • Facility Address: 5265 E HUNTINGTON AVENUE
    FRESNO, CA
    ZIP 93727
  • Facility Phone: 559 251-8244
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STEPHEN M. GROSSMAN
  • NPI Number: 1598323669
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0719592
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVERGREEN CARE CENTER
Street 5265 E HUNTINGTON AVENUE
City FRESNO
State CA
ZIP 93727
Phone 559 251-8244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director STEPHEN M. GROSSMAN

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