05D1008691 CLIA NUMBER - BRADBOURNE HEALTHCARE INC

Laboratory Demographics

  • CLIA Code: 05D1008691
  • Facility Name: BRADBOURNE HEALTHCARE INC
  • Facility Address: 1109 W SAN BERNARDINO RD, STE 230
    COVINA, CA
    ZIP 91722
  • Facility Phone: 626 814-0200
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: PRASERT B. VASSANTACHART
  • NPI Number: 1003948654
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1008691
LAB Type Home Health Agency
Facility Name BRADBOURNE HEALTHCARE INC
Street 1109 W SAN BERNARDINO RD, STE 230
City COVINA
State CA
ZIP 91722
Phone 626 814-0200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Home Health Agency
Lab Director PRASERT B. VASSANTACHART

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