05D2166542 CLIA NUMBER - DIGNICARE HOSPICE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 05D2166542
  • Facility Name: DIGNICARE HOSPICE SERVICES LLC
  • Facility Address: 520 E WILSON AVENUE, SUITE 105
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 975-0685
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: RODOLFO PROTACTIO
  • NPI Number: 1376967224
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2166542
LAB Type Hospice
Facility Name DIGNICARE HOSPICE SERVICES LLC
Street 520 E WILSON AVENUE, SUITE 105
City GLENDALE
State CA
ZIP 91206
Phone 818 975-0685
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Hospice
Lab Director RODOLFO PROTACTIO

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