05D2062986 CLIA NUMBER - BIXBY KNOLLS PLACE

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Field Name	Field Value
CLIA Number	05D2062986
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	BIXBY KNOLLS PLACE
Street	3706 PINE AVE
City	LONG BEACH
State	CA
ZIP	90807
Phone	562 595-9713
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/24/2025
Certificate Expiration Date	7/23/2027
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