05D2220026 CLIA NUMBER - ST MARKOSS HOSPICE INC

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Laboratory Demographics

CLIA Number: 05D2220026

Facility Name: ST MARKOSS HOSPICE INC

Facility Address:
5301 LAUREL CANYON BLVD SUITE 226
VALLEY VILLAGE, CA
ZIP 91607
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Facility Phone Number: 747 755-2020

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1306494034

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2220026
LAB Type	Hospice
Facility Name	ST MARKOSS HOSPICE INC
Street	5301 LAUREL CANYON BLVD SUITE 226
City	VALLEY VILLAGE
State	CA
ZIP	91607
Phone	747 755-2020
CertificateType	4
CertificateEffectiveDate	4/8/2023
CertificateExpirationDate	4/7/2025
FacilityType	Waiver

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