05D2319603 CLIA NUMBER - OAK GROVE MANOR, LLC

Laboratory Demographics

  • CLIA Code: 05D2319603
  • Facility Name: OAK GROVE MANOR, LLC
  • Facility Address: 3148 ARDEN AVENUE
    SAN BERNARDINO, CA
    ZIP 92404
  • Facility Phone: 818 281-5822
  • Facility Type: Other - CONGREGATE LIVING HEALTH
  • Facility Type: Waiver
  • Lab Director: FARBOD FARMAND
  • NPI Number: 1295519031
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2319603
LAB Type Other - CONGREGATE LIVING HEALTH
Facility Name OAK GROVE MANOR, LLC
Street 3148 ARDEN AVENUE
City SAN BERNARDINO
State CA
ZIP 92404
Phone 818 281-5822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Other - CONGREGATE LIVING HEALTH
Lab Director FARBOD FARMAND

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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