05D2065990 CLIA NUMBER - EL PORTAL - LOYD'S LIBERTY HOMES, INC

Laboratory Demographics

  • CLIA Code: 05D2065990
  • Facility Name: EL PORTAL - LOYD'S LIBERTY HOMES, INC
  • Facility Address: 450 EL PORTAL DR
    MERCED, CA
    ZIP 95340
  • Facility Phone: 559 451-0399
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: CHARLIE L. KANO, MD
  • NPI Number: 1184255135
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2065990
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name EL PORTAL - LOYD'S LIBERTY HOMES, INC
Street 450 EL PORTAL DR
City MERCED
State CA
ZIP 95340
Phone 559 451-0399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director CHARLIE L. KANO, MD

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