05D2136671 CLIA NUMBER - AMAZING GRACE OASIS

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CLIA Record

Field Name Field Value
CLIA Number 05D2136671
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name AMAZING GRACE OASIS
Street 13842 LEMONGRASS WAY
City HESPERIA
State CA
ZIP 92344
Phone 760 949-0431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director EZZAT NASHED

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