05D2018034 CLIA NUMBER - WESTERN CARE HOSPICE, INC

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Laboratory Demographics

CLIA Number: 05D2018034

Facility Name: WESTERN CARE HOSPICE, INC

Facility Address:
14545 VICTORY BLVD STE 505
VAN NUYS, CA
ZIP 91411
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Facility Phone Number: 818 787-7702

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1023328291

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2018034
LAB Type	Hospice
Facility Name	WESTERN CARE HOSPICE, INC
Street	14545 VICTORY BLVD STE 505
City	VAN NUYS
State	CA
ZIP	91411
Phone	818 787-7702
CertificateType	4
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	Waiver

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