05D2053221 CLIA NUMBER - LARK SPRING TERRACE, INC.

Laboratory Demographics

CLIA Code: 05D2053221
Facility Name: LARK SPRING TERRACE, INC.
Facility Address: 22504 LARK SPRING TERRACE
DIAMOND BAR, CA
ZIP 91765
Facility Phone: 909 860-2622
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: MICHAEL D. CHOI
NPI Number: 1164669446
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	05D2053221
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	LARK SPRING TERRACE, INC.
Street	22504 LARK SPRING TERRACE
City	DIAMOND BAR
State	CA
ZIP	91765
Phone	909 860-2622
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/28/2025
Certificate Expiration Date	1/27/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MICHAEL D. CHOI

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