05D2212252 CLIA NUMBER - BROOKDALE CORONA

Laboratory Demographics

  • CLIA Code: 05D2212252
  • Facility Name: BROOKDALE CORONA
  • Facility Address: 2005 KELLOGG AVE
    CORONA, CA
    ZIP 92879
  • Facility Phone: 951 898-6991
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LUKE WATSON
  • NPI Number: 1255542072
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2212252
LAB Type Assisted Living Facility
Facility Name BROOKDALE CORONA
Street 2005 KELLOGG AVE
City CORONA
State CA
ZIP 92879
Phone 951 898-6991
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Assisted Living Facility
Lab Director LUKE WATSON

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