05D2063203 CLIA NUMBER - ELIZABETH HOMES

Laboratory Demographics

  • CLIA Code: 05D2063203
  • Facility Name: ELIZABETH HOMES
  • Facility Address: 6280 SAN RICARDO WAY
    BUENA PARK, CA
    ZIP 90620
  • Facility Phone: 714 826-7627
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: SOLEDAD LEE, MD
  • NPI Number: 1407402852
  • Taxonomy: 3747A0650X - Technician

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CLIA Record

Field Name Field Value
CLIA Number 05D2063203
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ELIZABETH HOMES
Street 6280 SAN RICARDO WAY
City BUENA PARK
State CA
ZIP 90620
Phone 714 826-7627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director SOLEDAD LEE, MD

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