05D2303763 CLIA NUMBER - MONTE NIDO LAKE VISTA, LLC DBA CLEMENTINE ORANGE COUNTY

Laboratory Demographics

  • CLIA Code: 05D2303763
  • Facility Name: MONTE NIDO LAKE VISTA, LLC DBA CLEMENTINE ORANGE COUNTY
  • Facility Address: 17059 EL CAJON AVE
    YORBA LINDA, CA
    ZIP 92886
  • Facility Phone: 657 363-4633
  • Facility Type: Other - CONGREGATE LIVING HEALTH
  • Facility Type: Waiver
  • Lab Director: MOLLY M. PERLMAN
  • NPI Number: 1609501279
  • Taxonomy: 261QM0855X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2303763
LAB Type Other - CONGREGATE LIVING HEALTH
Facility Name MONTE NIDO LAKE VISTA, LLC DBA CLEMENTINE ORANGE COUNTY
Street 17059 EL CAJON AVE
City YORBA LINDA
State CA
ZIP 92886
Phone 657 363-4633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Other - CONGREGATE LIVING HEALTH
Lab Director MOLLY M. PERLMAN

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