05D0894687 CLIA NUMBER - CAMELLIA GARDENS CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0894687
  • Facility Name: CAMELLIA GARDENS CARE CENTER
  • Facility Address: 1920 NORTH FAIR OAKS AVENUE
    PASADENA, CA
    ZIP 91103
  • Facility Phone: 626 798-6777
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PETER C. BALACUIT
  • NPI Number: 1992864995
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0894687
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CAMELLIA GARDENS CARE CENTER
Street 1920 NORTH FAIR OAKS AVENUE
City PASADENA
State CA
ZIP 91103
Phone 626 798-6777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director PETER C. BALACUIT

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