05D2186624 CLIA NUMBER - JSI ACQUISITION DBA LIBERTANA HOME HEALTH

Laboratory Demographics

  • CLIA Code: 05D2186624
  • Facility Name: JSI ACQUISITION DBA LIBERTANA HOME HEALTH
  • Facility Address: 5805 SEPULVEDA BLVD STE 605
    SHERMAN OAKS, CA
    ZIP 91411
  • Facility Phone: 818 902-5000
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DR. DAVID N. KAY
  • NPI Number: 1013967314
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2186624
LAB Type Home Health Agency
Facility Name JSI ACQUISITION DBA LIBERTANA HOME HEALTH
Street 5805 SEPULVEDA BLVD STE 605
City SHERMAN OAKS
State CA
ZIP 91411
Phone 818 902-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Home Health Agency
Lab Director DR. DAVID N. KAY

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