05D2035294 CLIA NUMBER - MARY'S HOUSE

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Field Name	Field Value
CLIA Number	05D2035294
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MARY'S HOUSE
Street	14901 CONDON AVE
City	LAWNDALE
State	CA
ZIP	90260
Phone	310 675-2887
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/13/2024
Certificate Expiration Date	1/12/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	EUGENE HARDIN

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