05D2123040 CLIA NUMBER - DIVINE MERCY HOME HEALTHCARE INC

Laboratory Demographics

  • CLIA Code: 05D2123040
  • Facility Name: DIVINE MERCY HOME HEALTHCARE INC
  • Facility Address: 805 E BROADWAY STE H
    GLENDALE, CA
    ZIP 91205
  • Facility Phone: 818 551-0079
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: VAHAN MADATOVIAN
  • NPI Number: 1497152144
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2123040
LAB Type Home Health Agency
Facility Name DIVINE MERCY HOME HEALTHCARE INC
Street 805 E BROADWAY STE H
City GLENDALE
State CA
ZIP 91205
Phone 818 551-0079
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Home Health Agency
Lab Director VAHAN MADATOVIAN

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