05D2295057 CLIA NUMBER - LAGLEN HOME INC

Laboratory Demographics

  • CLIA Code: 05D2295057
  • Facility Name: LAGLEN HOME INC
  • Facility Address: 639 S GLENWOOD PL, UNIT 105
    BURBANK, CA
    ZIP 91506
  • Facility Phone: 747 333-3012
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: BERJ DERMENDJIAN
  • NPI Number: 1689262487
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2295057
LAB Type Home Health Agency
Facility Name LAGLEN HOME INC
Street 639 S GLENWOOD PL, UNIT 105
City BURBANK
State CA
ZIP 91506
Phone 747 333-3012
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Home Health Agency
Lab Director BERJ DERMENDJIAN

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