05D2230210 CLIA NUMBER - LIMAR ADULT DAT HEALTH CARE CENTER INC

Laboratory Demographics

CLIA Number: 05D2230210

Facility Name: LIMAR ADULT DAT HEALTH CARE CENTER INC

Facility Address:
2809 TWEEDY BLVD UNIT B
SOUTH GATE, CA
ZIP 90280
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Facility Phone Number: 323 810-5090

Facility Type: Other - CBAS/ADHC CENTER

Certificate Type: Waiver

NPI Number: 1639664782

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2230210
LAB Type	Other - CBAS/ADHC CENTER
Facility Name	LIMAR ADULT DAT HEALTH CARE CENTER INC
Street	2809 TWEEDY BLVD UNIT B
City	SOUTH GATE
State	CA
ZIP	90280
Phone	323 810-5090
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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