05D0880902 CLIA NUMBER - ANTELOPE VALLEY CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0880902
  • Facility Name: ANTELOPE VALLEY CARE CENTER
  • Facility Address: 44567 N 15TH ST W
    LANCASTER, CA
    ZIP 93534
  • Facility Phone: 661 949-5524
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ATEF MOUSA
  • NPI Number: 1609857275
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0880902
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ANTELOPE VALLEY CARE CENTER
Street 44567 N 15TH ST W
City LANCASTER
State CA
ZIP 93534
Phone 661 949-5524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ATEF MOUSA

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