05D2112609 CLIA NUMBER - MATRIX HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2112609
  • Facility Name: MATRIX HOSPICE INC
  • Facility Address: 17141 VENTURA BLVD SUITE 205
    ENCINO, CA
    ZIP 91316
  • Facility Phone: 310 997-2549
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MOSTAFA RAHIMI
  • NPI Number: 1013355031
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2112609
LAB Type Hospice
Facility Name MATRIX HOSPICE INC
Street 17141 VENTURA BLVD SUITE 205
City ENCINO
State CA
ZIP 91316
Phone 310 997-2549
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Hospice
Lab Director MOSTAFA RAHIMI

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