05D1022694 CLIA NUMBER - ST MARTIN HOME HEALTHCARE

Laboratory Demographics

  • CLIA Code: 05D1022694
  • Facility Name: ST MARTIN HOME HEALTHCARE
  • Facility Address: 13771 ROSWELL AVE STE H
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 627-0408
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANTO V. MALIAKKAL
  • NPI Number: 1619927746
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1022694
LAB Type Home Health Agency
Facility Name ST MARTIN HOME HEALTHCARE
Street 13771 ROSWELL AVE STE H
City CHINO
State CA
ZIP 91710
Phone 909 627-0408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Home Health Agency
Lab Director ANTO V. MALIAKKAL

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