05D1084092 CLIA NUMBER - LIGHTHOUSE LABS

Laboratory Demographics

CLIA Code: 05D1084092
Facility Name: LIGHTHOUSE LABS
Facility Address: 17001 SAGA DR
YORBA LINDA, CA
ZIP 92886
Facility Phone: 714 223-1220
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: PRAFUL A. SARODE MD
NPI Number: 1265862973
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	05D1084092
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	LIGHTHOUSE LABS
Street	17001 SAGA DR
City	YORBA LINDA
State	CA
ZIP	92886
Phone	714 223-1220
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	5/2/2024
Certificate Expiration Date	5/1/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	PRAFUL A. SARODE MD

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