05D2032110 CLIA NUMBER - LIBERTY HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2032110
  • Facility Name: LIBERTY HOSPICE INC
  • Facility Address: 1111 N BRAND BLVD STE 314
    GLENDALE, CA
    ZIP 91202
  • Facility Phone: 818 242-6000
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MINAS KOCHUMIAN
  • NPI Number: 1134418114
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2032110
LAB Type Hospice
Facility Name LIBERTY HOSPICE INC
Street 1111 N BRAND BLVD STE 314
City GLENDALE
State CA
ZIP 91202
Phone 818 242-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Hospice
Lab Director MINAS KOCHUMIAN

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