05D0989722 CLIA NUMBER - JAN & GAIL'S CARE HOME #1

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Field Name	Field Value
CLIA Number	05D0989722
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	JAN & GAIL'S CARE HOME #1
Street	134 N SANTA CLARA STREET
City	TULARE
State	CA
ZIP	93274
Phone	559 686-3090
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/3/2025
Certificate Expiration Date	8/2/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	RON MARCONI MD

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