05D2136266 CLIA NUMBER - BLUE JAY MANOR, LLC

Laboratory Demographics

  • CLIA Code: 05D2136266
  • Facility Name: BLUE JAY MANOR, LLC
  • Facility Address: 35 BLUE JAY
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 909 228-8630
  • Facility Type: Other - CLHF
  • Facility Type: Waiver
  • Lab Director: RAJIV BHUVA, MD
  • NPI Number: 1568901809
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2136266
LAB Type Other - CLHF
Facility Name BLUE JAY MANOR, LLC
Street 35 BLUE JAY
City REDLANDS
State CA
ZIP 92374
Phone 909 228-8630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Other - CLHF
Lab Director RAJIV BHUVA, MD

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