05D1080086 CLIA NUMBER - CEDAR HOUSE

Laboratory Demographics

CLIA Code: 05D1080086
Facility Name: CEDAR HOUSE
Facility Address: 6384 N 10TH ST
FRESNO, CA
ZIP 93710
Facility Phone: 559 322-9305
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: ASHA SIDHU
NPI Number: 1598972622
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	05D1080086
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	CEDAR HOUSE
Street	6384 N 10TH ST
City	FRESNO
State	CA
ZIP	93710
Phone	559 322-9305
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/27/2024
Certificate Expiration Date	10/26/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ASHA SIDHU

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