05D2203777 CLIA NUMBER - PIERCE CONGREGATE LIVING LLC

Laboratory Demographics

  • CLIA Code: 05D2203777
  • Facility Name: PIERCE CONGREGATE LIVING LLC
  • Facility Address: 12430 PIERCE ST
    PACOIMA, CA
    ZIP 91331
  • Facility Phone: 818 307-3675
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. MANUEL MANRIQUE
  • NPI Number: 1548804255
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2203777
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PIERCE CONGREGATE LIVING LLC
Street 12430 PIERCE ST
City PACOIMA
State CA
ZIP 91331
Phone 818 307-3675
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. MANUEL MANRIQUE

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