05D2095738 CLIA NUMBER - NEW AGE ENTERPRISES DBA SGV HOME HEALTH

Laboratory Demographics

  • CLIA Code: 05D2095738
  • Facility Name: NEW AGE ENTERPRISES DBA SGV HOME HEALTH
  • Facility Address: 817 W BEVERLY BLVD STE 206
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 278-0995
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: RICHARD PARK
  • NPI Number: 1871998492
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2095738
LAB Type Home Health Agency
Facility Name NEW AGE ENTERPRISES DBA SGV HOME HEALTH
Street 817 W BEVERLY BLVD STE 206
City MONTEBELLO
State CA
ZIP 90640
Phone 323 278-0995
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Home Health Agency
Lab Director RICHARD PARK

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