05D2180643 CLIA NUMBER - SUPERB HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2180643
  • Facility Name: SUPERB HOSPICE INC
  • Facility Address: 14545 FRIAR STREET SUITE 170
    VAN NUYS, CA
    ZIP 91411
  • Facility Phone: 818 646-1910
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NESTOR LAZARO
  • NPI Number: 1184262842
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2180643
LAB Type Hospice
Facility Name SUPERB HOSPICE INC
Street 14545 FRIAR STREET SUITE 170
City VAN NUYS
State CA
ZIP 91411
Phone 818 646-1910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Hospice
Lab Director NESTOR LAZARO

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