05D2159897 CLIA NUMBER - SO CAL HOSPICE CARE INC

Laboratory Demographics

  • CLIA Code: 05D2159897
  • Facility Name: SO CAL HOSPICE CARE INC
  • Facility Address: 11507 OXNARD STREET #5
    NORTH HOLLYWOOD, CA
    ZIP 91606
  • Facility Phone: 818 358-3342
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NATTAPAUN THEPYASUWAN
  • NPI Number: 1811255458
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2159897
LAB Type Hospice
Facility Name SO CAL HOSPICE CARE INC
Street 11507 OXNARD STREET #5
City NORTH HOLLYWOOD
State CA
ZIP 91606
Phone 818 358-3342
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Hospice
Lab Director NATTAPAUN THEPYASUWAN

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