05D2223252 CLIA NUMBER - BRIGHT SOURCE HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 05D2223252
  • Facility Name: BRIGHT SOURCE HOSPICE, LLC
  • Facility Address: 22024 LASSEN STREET OFFICE 113
    CHATSWORTH, CA
    ZIP 91311
  • Facility Phone: 747 200-7663
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROBERT LADINES
  • NPI Number: 1093337784
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2223252
LAB Type Hospice
Facility Name BRIGHT SOURCE HOSPICE, LLC
Street 22024 LASSEN STREET OFFICE 113
City CHATSWORTH
State CA
ZIP 91311
Phone 747 200-7663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Hospice
Lab Director ROBERT LADINES

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