05D2292337 CLIA NUMBER - SOCAL INTEGRATED CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2292337
  • Facility Name: SOCAL INTEGRATED CARE, INC
  • Facility Address: 1220 W GLENOAKS BLVD STE 102
    GLENDALE, CA
    ZIP 91201
  • Facility Phone: 818 305-5054
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: PABLO J. BASSUK
  • NPI Number: 1689284606
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2292337
LAB Type Home Health Agency
Facility Name SOCAL INTEGRATED CARE, INC
Street 1220 W GLENOAKS BLVD STE 102
City GLENDALE
State CA
ZIP 91201
Phone 818 305-5054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Home Health Agency
Lab Director PABLO J. BASSUK

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