05D2095752 CLIA NUMBER - CASA SAO JORGE

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Field Name	Field Value
CLIA Number	05D2095752
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	CASA SAO JORGE
Street	5555 N MAROA AVE
City	FRESNO
State	CA
ZIP	93704
Phone	559 485-5555
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	5/11/2025
Certificate Expiration Date	5/10/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	ASH PRITPAL S. SIDHU

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