05D2168914 CLIA NUMBER - AUTHENTIC HOSPICE CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2168914
  • Facility Name: AUTHENTIC HOSPICE CARE, INC
  • Facility Address: 2667 N MOORPARK ROAD, SUITE 205
    THOUSAND OAKS, CA
    ZIP 91360
  • Facility Phone: 805 241-4404
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NESTOR LAZARO
  • NPI Number: 1750857975
  • Taxonomy: 251G00000X - Hospice Care, Community Based

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2168914
LAB Type Hospice
Facility Name AUTHENTIC HOSPICE CARE, INC
Street 2667 N MOORPARK ROAD, SUITE 205
City THOUSAND OAKS
State CA
ZIP 91360
Phone 805 241-4404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Hospice
Lab Director NESTOR LAZARO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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