05D2202041 CLIA NUMBER - DIVINE GRACE HOSPICE

Laboratory Demographics

  • CLIA Code: 05D2202041
  • Facility Name: DIVINE GRACE HOSPICE
  • Facility Address: 4766 PARK GRANADA SUITE 106
    CALABASAS, CA
    ZIP 91302
  • Facility Phone: 626 265-4565
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: BORNA SOLOMON
  • NPI Number: 1033549936
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2202041
LAB Type Hospice
Facility Name DIVINE GRACE HOSPICE
Street 4766 PARK GRANADA SUITE 106
City CALABASAS
State CA
ZIP 91302
Phone 626 265-4565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Hospice
Lab Director BORNA SOLOMON

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