05D1070882 CLIA NUMBER - CORAL HOME

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Field Name	Field Value
CLIA Number	05D1070882
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	CORAL HOME
Street	2090 BOLIVAR COURT
City	SIMI VALLEY
State	CA
ZIP	93063
Phone	805 527-4370
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/8/2024
Certificate Expiration Date	9/7/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ZIA ABDO M. MEMAR

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