05D0725770 CLIA NUMBER - MONTCLAIR MANOR CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0725770
  • Facility Name: MONTCLAIR MANOR CARE CENTER
  • Facility Address: 5119 BANDERA ST
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 626-1294
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM TSAI
  • NPI Number: 1689661357
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0725770
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MONTCLAIR MANOR CARE CENTER
Street 5119 BANDERA ST
City MONTCLAIR
State CA
ZIP 91763
Phone 909 626-1294
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 WILLIAM TSAI

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