05D2266358 CLIA NUMBER - VIDACARE, INC.

Laboratory Demographics

  • CLIA Code: 05D2266358
  • Facility Name: VIDACARE, INC.
  • Facility Address: 13701 RIVERSIDE DRIVE SUITE 705
    SHERMAN OAKS, CA
    ZIP 91423
  • Facility Phone: 818 809-2441
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: BERJ DERMENDJIAN
  • NPI Number: 1235785858
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2266358
LAB Type Home Health Agency
Facility Name VIDACARE, INC.
Street 13701 RIVERSIDE DRIVE SUITE 705
City SHERMAN OAKS
State CA
ZIP 91423
Phone 818 809-2441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Home Health Agency
Lab Director BERJ DERMENDJIAN

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