05D0933811 CLIA NUMBER - EXCEL HOME HEALTH

Laboratory Demographics

  • CLIA Code: 05D0933811
  • Facility Name: EXCEL HOME HEALTH
  • Facility Address: 5575 LAKE PARK WAY, SUITE #220
    LA MESA, CA
    ZIP 91942
  • Facility Phone: 619 460-6622
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: VENU PRABAKER MD
  • NPI Number: 1336230689
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0933811
LAB Type Home Health Agency
Facility Name EXCEL HOME HEALTH
Street 5575 LAKE PARK WAY, SUITE #220
City LA MESA
State CA
ZIP 91942
Phone 619 460-6622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2025
Certificate Expiration Date 10/6/2027
Facility Type Home Health Agency
Lab Director VENU PRABAKER MD

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