05D0704728 CLIA NUMBER - JEWISH HOME FOR THE AGING EISENBERG VILLAGE

Laboratory Demographics

  • CLIA Code: 05D0704728
  • Facility Name: JEWISH HOME FOR THE AGING EISENBERG VILLAGE
  • Facility Address: 18855 VICTORY BOULEVARD
    RESEDA, CA
    ZIP 91335
  • Facility Phone: 818 774-3000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RICK SMITH MD
  • NPI Number: 1417382680
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0704728
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name JEWISH HOME FOR THE AGING EISENBERG VILLAGE
Street 18855 VICTORY BOULEVARD
City RESEDA
State CA
ZIP 91335
Phone 818 774-3000
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 RICK SMITH MD

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