05D0888783 CLIA NUMBER - CLAREMONT MANOR CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0888783
  • Facility Name: CLAREMONT MANOR CARE CENTER
  • Facility Address: 621 W BONITA AVE
    CLAREMONT, CA
    ZIP 91711
  • Facility Phone: 909 626-1227
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARY N. KASEM
  • NPI Number: 1760738850
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0888783
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CLAREMONT MANOR CARE CENTER
Street 621 W BONITA AVE
City CLAREMONT
State CA
ZIP 91711
Phone 909 626-1227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARY N. KASEM

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