05D2186692 CLIA NUMBER - HEAVEN ROADS HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2186692
  • Facility Name: HEAVEN ROADS HOSPICE INC
  • Facility Address: 14545 FRIAR ST SUITE 136
    VAN NUYS, CA
    ZIP 91411
  • Facility Phone: 818 285-8943
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DOMINGO BARRIENTOS
  • NPI Number: 1891329892
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2186692
LAB Type Hospice
Facility Name HEAVEN ROADS HOSPICE INC
Street 14545 FRIAR ST SUITE 136
City VAN NUYS
State CA
ZIP 91411
Phone 818 285-8943
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 Hospice
Lab Director DOMINGO BARRIENTOS

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