05D2113845 CLIA NUMBER - MISSION CITY COMMUNITY NETWORK INC

Laboratory Demographics

  • CLIA Code: 05D2113845
  • Facility Name: MISSION CITY COMMUNITY NETWORK INC
  • Facility Address: 8771 VAN NUYS BLVD
    PANORAMA CITY, CA
    ZIP 91402
  • Facility Phone: 818 895-3100
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PAUL MALABANAN
  • NPI Number: 1992246979
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2113845
LAB Type Community Clinic
Facility Name MISSION CITY COMMUNITY NETWORK INC
Street 8771 VAN NUYS BLVD
City PANORAMA CITY
State CA
ZIP 91402
Phone 818 895-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Community Clinic
Lab Director PAUL MALABANAN

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