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05D2184547 CLIA NUMBER - VALLEY COMMUNITY HOSPICE, INC

Laboratory Demographics

CLIA Number: 05D2184547

Facility Name: VALLEY COMMUNITY HOSPICE, INC

Facility Address:
12501 CHANDLER BLVD, SUITE 105
VALLEY VILLAGE, CA
ZIP 91607
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Facility Phone Number: 818 691-3407

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1285115600

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 05D2184547
LAB Type Hospice
Facility Name VALLEY COMMUNITY HOSPICE, INC
Street 12501 CHANDLER BLVD, SUITE 105
City VALLEY VILLAGE
State CA
ZIP 91607
Phone 818 691-3407
CertificateType 4
CertificateEffectiveDate 5/21/2022
CertificateExpirationDate 5/20/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024