05D1088762 CLIA NUMBER - QUINTANA HOME

Laboratory Demographics

CLIA Code: 05D1088762
Facility Name: QUINTANA HOME
Facility Address: 24522 QUINTANA DR
MISSION VIEJO, CA
ZIP 92691
Facility Phone: 949 916-9234
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: CHRISTOPHER HOLDEN MD
NPI Number: 1407002033
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	05D1088762
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	QUINTANA HOME
Street	24522 QUINTANA DR
City	MISSION VIEJO
State	CA
ZIP	92691
Phone	949 916-9234
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/3/2024
Certificate Expiration Date	9/2/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	CHRISTOPHER HOLDEN MD

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