05D2116475 CLIA NUMBER - LOGAN'S HOME

Laboratory Demographics

  • CLIA Code: 05D2116475
  • Facility Name: LOGAN'S HOME
  • Facility Address: 7683 HEATHER CIRCLE
    BUENA PARK, CA
    ZIP 90620
  • Facility Phone: 714 752-6830
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: ARNEL JOAQUIN
  • NPI Number: 1144647512
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2116475
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name LOGAN'S HOME
Street 7683 HEATHER CIRCLE
City BUENA PARK
State CA
ZIP 90620
Phone 714 752-6830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director ARNEL JOAQUIN

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