05D2293353 CLIA NUMBER - ANGEL CONGREGATE LIVING, INC

Laboratory Demographics

  • CLIA Code: 05D2293353
  • Facility Name: ANGEL CONGREGATE LIVING, INC
  • Facility Address: 38536 DESERT VIEW DRIVE
    PALMDALE, CA
    ZIP 93551
  • Facility Phone: 661 418-5830
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ATEF MOUSA
  • NPI Number: 1568869303
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2293353
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ANGEL CONGREGATE LIVING, INC
Street 38536 DESERT VIEW DRIVE
City PALMDALE
State CA
ZIP 93551
Phone 661 418-5830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ATEF MOUSA

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