05D1002635 CLIA NUMBER - PRISTINE HOME HEALTH, INC

Laboratory Demographics

  • CLIA Code: 05D1002635
  • Facility Name: PRISTINE HOME HEALTH, INC
  • Facility Address: 1419 N SAN FERNANDO BLVD, #100
    BURBANK, CA
    ZIP 91504
  • Facility Phone: 818 582-4110
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: NICHOLAS M. PANAGIOTIS
  • NPI Number: 1780007096
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1002635
LAB Type Home Health Agency
Facility Name PRISTINE HOME HEALTH, INC
Street 1419 N SAN FERNANDO BLVD, #100
City BURBANK
State CA
ZIP 91504
Phone 818 582-4110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Home Health Agency
Lab Director NICHOLAS M. PANAGIOTIS

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