05D1066905 CLIA NUMBER - UNITED CEREBRAL PALSY OF LA & VENTURA COUNTIES

Laboratory Demographics

CLIA Number: 05D1066905

Facility Name: UNITED CEREBRAL PALSY OF LA & VENTURA COUNTIES

Facility Address:
6430 INDEPENDENCE AVE
WOODLAND HILLS, CA
ZIP 91367
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Facility Phone Number: 818 782-2211

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1720254535

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	05D1066905
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	UNITED CEREBRAL PALSY OF LA & VENTURA COUNTIES
Street	6430 INDEPENDENCE AVE
City	WOODLAND HILLS
State	CA
ZIP	91367
Phone	818 782-2211
CertificateType	4
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024