05D1003894 CLIA NUMBER - ORCHID COURT INC DBA CAMELOT ADULT DAY HEALTH CARE CTR

Laboratory Demographics

CLIA Number: 05D1003894

Facility Name: ORCHID COURT INC DBA CAMELOT ADULT DAY HEALTH CARE CTR

Facility Address:
650 CAMINO REAL CIRCLE
HEMET, CA
ZIP 92543
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Facility Phone Number: 909 884-3044

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1720298763

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1003894
LAB Type	Ambulance
Facility Name	ORCHID COURT INC DBA CAMELOT ADULT DAY HEALTH CARE CTR
Street	650 CAMINO REAL CIRCLE
City	HEMET
State	CA
ZIP	92543
Phone	909 884-3044
CertificateType	4
CertificateEffectiveDate	9/13/2022
CertificateExpirationDate	9/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024