05D1045415 CLIA NUMBER - DOUGLASS HOME

Laboratory Demographics

Get Directions

Field Name	Field Value
CLIA Number	05D1045415
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	DOUGLASS HOME
Street	1408 DOUGLASS DR
City	POMONA
State	CA
ZIP	91768
Phone	714 939-2081
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/15/2024
Certificate Expiration Date	7/14/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	LARRY VIGILIA

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