05D0561881 CLIA NUMBER - VALLEY MANOR CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0561881
  • Facility Name: VALLEY MANOR CONVALESCENT HOSPITAL
  • Facility Address: 6120 NO VINELAND AVENUE
    NORTH HOLLYWOOD, CA
    ZIP 91606
  • Facility Phone: 818 763-6275
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DOROTHY PENA
  • NPI Number: 1902895972
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0561881
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VALLEY MANOR CONVALESCENT HOSPITAL
Street 6120 NO VINELAND AVENUE
City NORTH HOLLYWOOD
State CA
ZIP 91606
Phone 818 763-6275
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DOROTHY PENA

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