05D2160488 CLIA NUMBER - VRT HOME HEALTH CARE

Laboratory Demographics

  • CLIA Code: 05D2160488
  • Facility Name: VRT HOME HEALTH CARE
  • Facility Address: 600 W BROADWAY SUITE 240B
    GLENDALE, CA
    ZIP 91204
  • Facility Phone: 818 813-4101
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DR. HANI ADIEP BENYAMIN AJAIPI
  • NPI Number: 1639650666
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2160488
LAB Type Home Health Agency
Facility Name VRT HOME HEALTH CARE
Street 600 W BROADWAY SUITE 240B
City GLENDALE
State CA
ZIP 91204
Phone 818 813-4101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Home Health Agency
Lab Director DR. HANI ADIEP BENYAMIN AJAIPI

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