05D2289392 CLIA NUMBER - HANSEN COMMUNITY CARE

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CLIA Record

Field Name Field Value
CLIA Number 05D2289392
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name HANSEN COMMUNITY CARE
Street 12943 WINGO ST
City PACOIMA
State CA
ZIP 91331
Phone 747 367-0241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KAJANI SIKANDER

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