05D2115475 CLIA NUMBER - BALDWIN PARK CONGREGATE HOME INC

Laboratory Demographics

  • CLIA Code: 05D2115475
  • Facility Name: BALDWIN PARK CONGREGATE HOME INC
  • Facility Address: 3462 VINELAND AVE
    BALDWIN PARK, CA
    ZIP 91706
  • Facility Phone: 626 960-6500
  • Facility Type: Other - CHLF
  • Facility Type: Waiver
  • Lab Director: KAMALAKAR RAMBHATLA
  • NPI Number: 1194125658
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2115475
LAB Type Other - CHLF
Facility Name BALDWIN PARK CONGREGATE HOME INC
Street 3462 VINELAND AVE
City BALDWIN PARK
State CA
ZIP 91706
Phone 626 960-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2024
Certificate Expiration Date 7/6/2026
Facility Type Other - CHLF
Lab Director KAMALAKAR RAMBHATLA

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