05D0901507 CLIA NUMBER - WEST HAVEN HEALTHCARE

Laboratory Demographics

  • CLIA Code: 05D0901507
  • Facility Name: WEST HAVEN HEALTHCARE
  • Facility Address: 1495 W CAMERON AVE
    WEST COVINA, CA
    ZIP 91790
  • Facility Phone: 626 962-4461
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: OLIVER SOLOMON
  • NPI Number: 1912134263
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0901507
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WEST HAVEN HEALTHCARE
Street 1495 W CAMERON AVE
City WEST COVINA
State CA
ZIP 91790
Phone 626 962-4461
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director OLIVER SOLOMON

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