05D2121500 CLIA NUMBER - LONGEVITY HOSPICE CARE SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2121500
  • Facility Name: LONGEVITY HOSPICE CARE SERVICES INC
  • Facility Address: 229 N CENTRAL AVE STE 607
    GLENDALE, CA
    ZIP 91203
  • Facility Phone: 818 334-6243
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: STEPHEN NATHAN PINE
  • NPI Number: 1033517610
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2121500
LAB Type Hospice
Facility Name LONGEVITY HOSPICE CARE SERVICES INC
Street 229 N CENTRAL AVE STE 607
City GLENDALE
State CA
ZIP 91203
Phone 818 334-6243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Hospice
Lab Director STEPHEN NATHAN PINE

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