05D0992836 CLIA NUMBER - ANAHEIM VIP ADULT DAY HEALTH CARE CTR

Laboratory Demographics

  • CLIA Code: 05D0992836
  • Facility Name: ANAHEIM VIP ADULT DAY HEALTH CARE CTR
  • Facility Address: 1158 N KNOLLWOOD CIRCLE
    ANAHEIM, CA
    ZIP 92801
  • Facility Phone: 714 220-2414
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HARRY L. SOE,PMS,A MD
  • NPI Number: 1770709305
  • Taxonomy: 261QH0100X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0992836
LAB Type Other
Facility Name ANAHEIM VIP ADULT DAY HEALTH CARE CTR
Street 1158 N KNOLLWOOD CIRCLE
City ANAHEIM
State CA
ZIP 92801
Phone 714 220-2414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Other
Lab Director HARRY L. SOE,PMS,A MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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