05D2259843 CLIA NUMBER - VANITY WELLNESS CENTER

Laboratory Demographics

CLIA Number: 05D2259843

Facility Name: VANITY WELLNESS CENTER

Facility Address:
19935 VENTURA BLVD SUITE 1
WOODLAND HILLS, CA
ZIP 91364
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Facility Phone Number: 818 454-5112

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1609476845

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2259843
LAB Type	Independent
Facility Name	VANITY WELLNESS CENTER
Street	19935 VENTURA BLVD SUITE 1
City	WOODLAND HILLS
State	CA
ZIP	91364
Phone	818 454-5112
CertificateType	4
CertificateEffectiveDate	5/11/2024
CertificateExpirationDate	5/10/2026
FacilityType	Waiver

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