05D2196626 CLIA NUMBER - MONTE NIDO LAKE VISTA LLC DBA MONTE NIDO EAST BAY

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CLIA Record

Field Name Field Value
CLIA Number 05D2196626
LAB Type Other - RES MENTAL HLTH FACILITY
Facility Name MONTE NIDO LAKE VISTA LLC DBA MONTE NIDO EAST BAY
Street 1776 IVANHOE AVE
City LAFAYETTE
State CA
ZIP 94549
Phone 925 660-0755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Other - RES MENTAL HLTH FACILITY
Lab Director MOLLY M. PERLMAN

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