05D2150334 CLIA NUMBER - CARSON HEALTHCARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 05D2150334
  • Facility Name: CARSON HEALTHCARE SERVICES LLC
  • Facility Address: 17625 SOUTH CENTRAL AVE STE H
    CARSON, CA
    ZIP 90746
  • Facility Phone: 310 228-8682
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JANIS OWEN, MD
  • NPI Number: 1174992598
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2150334
LAB Type Home Health Agency
Facility Name CARSON HEALTHCARE SERVICES LLC
Street 17625 SOUTH CENTRAL AVE STE H
City CARSON
State CA
ZIP 90746
Phone 310 228-8682
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Home Health Agency
Lab Director JANIS OWEN, MD

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