05D2182867 CLIA NUMBER - THOREAU HOUSE II

Laboratory Demographics

  • CLIA Code: 05D2182867
  • Facility Name: THOREAU HOUSE II
  • Facility Address: 1948 THOREAU STREET
    LOS ANGELES, CA
    ZIP 90047
  • Facility Phone: 323 755-7121
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: EUGENE HARDIN
  • NPI Number: 1356790786
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2182867
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name THOREAU HOUSE II
Street 1948 THOREAU STREET
City LOS ANGELES
State CA
ZIP 90047
Phone 323 755-7121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director EUGENE HARDIN

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