05D2218044 CLIA NUMBER - BELOVED HOSPICE INC

Laboratory Demographics

CLIA Number: 05D2218044

Facility Name: BELOVED HOSPICE INC

Facility Address:
6819 SEPULVEDA BLVD STE 208
VAN NUYS, CA
ZIP 91405
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Facility Phone Number: 818 745-5092

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1689285231

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2218044
LAB Type	Hospice
Facility Name	BELOVED HOSPICE INC
Street	6819 SEPULVEDA BLVD STE 208
City	VAN NUYS
State	CA
ZIP	91405
Phone	818 745-5092
CertificateType	4
CertificateEffectiveDate	3/25/2023
CertificateExpirationDate	3/24/2025
FacilityType	Waiver

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