05D2215973 CLIA NUMBER - SILVERADO SIERRA VISTA LLC

Laboratory Demographics

CLIA Number: 05D2215973

Facility Name: SILVERADO SIERRA VISTA LLC

Facility Address:
125 W SIERRA MADRE AVE
AZUSA, CA
ZIP 91702
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Facility Phone Number: 626 812-9777

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1760145817

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2215973
LAB Type	Assisted Living Facility
Facility Name	SILVERADO SIERRA VISTA LLC
Street	125 W SIERRA MADRE AVE
City	AZUSA
State	CA
ZIP	91702
Phone	626 812-9777
CertificateType	4
CertificateEffectiveDate	3/9/2023
CertificateExpirationDate	3/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024