05D2170888 CLIA NUMBER - CANYON VISTA POST ACUTE LLC

Laboratory Demographics

  • CLIA Code: 05D2170888
  • Facility Name: CANYON VISTA POST ACUTE LLC
  • Facility Address: 20554 ROSCOE BOULEVARD
    CANOGA PARK, CA
    ZIP 91306
  • Facility Phone: 818 401-1493
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBBY AYOUB
  • NPI Number: 1093223729
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2170888
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CANYON VISTA POST ACUTE LLC
Street 20554 ROSCOE BOULEVARD
City CANOGA PARK
State CA
ZIP 91306
Phone 818 401-1493
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROBBY AYOUB

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