05D2204598 CLIA NUMBER - MALIBU HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2204598
  • Facility Name: MALIBU HOSPICE INC
  • Facility Address: 30101 AGOURA ST ROAD SUITE #236A
    AGOURA HILLS, CA
    ZIP 91301
  • Facility Phone: 424 325-8231
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: BORIS VAISMAN
  • NPI Number: 1699381236
  • Taxonomy: 251G00000X - Hospice Care, Community Based

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2204598
LAB Type Hospice
Facility Name MALIBU HOSPICE INC
Street 30101 AGOURA ST ROAD SUITE #236A
City AGOURA HILLS
State CA
ZIP 91301
Phone 424 325-8231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Hospice
Lab Director BORIS VAISMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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