05D0885428 CLIA NUMBER - COLONIAL CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0885428
  • Facility Name: COLONIAL CARE CENTER
  • Facility Address: 1913 E 5TH ST
    LONG BEACH, CA
    ZIP 90802
  • Facility Phone: 562 432-5751
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VANNARITH SO, MD
  • NPI Number: 1639257165
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0885428
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COLONIAL CARE CENTER
Street 1913 E 5TH ST
City LONG BEACH
State CA
ZIP 90802
Phone 562 432-5751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VANNARITH SO, MD

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