05D1045776 CLIA NUMBER - GEMSONS CORP DBA ST LUKE HOME HEALTH

Laboratory Demographics

  • CLIA Code: 05D1045776
  • Facility Name: GEMSONS CORP DBA ST LUKE HOME HEALTH
  • Facility Address: 412 W BROADWAY STE 216
    GLENDALE, CA
    ZIP 91204
  • Facility Phone: 818 956-9878
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: LARRY P. VIGILIA
  • NPI Number: 1255543211
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1045776
LAB Type Home Health Agency
Facility Name GEMSONS CORP DBA ST LUKE HOME HEALTH
Street 412 W BROADWAY STE 216
City GLENDALE
State CA
ZIP 91204
Phone 818 956-9878
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Home Health Agency
Lab Director LARRY P. VIGILIA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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