05D2148020 CLIA NUMBER - MOONLIGHT HOME HEALTH CARE INC

Laboratory Demographics

CLIA Number: 05D2148020

Facility Name: MOONLIGHT HOME HEALTH CARE INC

Facility Address:
348 E OLIVE AVE STE K
BURBANK, CA
ZIP 91502
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Facility Phone Number: 818 429-0797

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1205297314

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2148020
LAB Type	Home Health Agency
Facility Name	MOONLIGHT HOME HEALTH CARE INC
Street	348 E OLIVE AVE STE K
City	BURBANK
State	CA
ZIP	91502
Phone	818 429-0797
CertificateType	4
CertificateEffectiveDate	5/2/2024
CertificateExpirationDate	5/1/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024