05D1069872 CLIA NUMBER - JADE HOME EPIPHANY CARE HOMES INC

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Field Name	Field Value
CLIA Number	05D1069872
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	JADE HOME EPIPHANY CARE HOMES INC
Street	750 KENTWOOD DR
City	OXNARD
State	CA
ZIP	93030
Phone	805 983-4785
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/14/2025
Certificate Expiration Date	6/13/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ABDO MEMAR-ZIA

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