05D2296323 CLIA NUMBER - STATIM CARE HOSPICE, INC

Laboratory Demographics

  • CLIA Code: 05D2296323
  • Facility Name: STATIM CARE HOSPICE, INC
  • Facility Address: 21243 VENTURA BLVD STE 110
    WOODLAND HILLS, CA
    ZIP 91364
  • Facility Phone: 818 570-1670
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: AUDRA E. FORD
  • NPI Number: 1811507528
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2296323
LAB Type Hospital
Facility Name STATIM CARE HOSPICE, INC
Street 21243 VENTURA BLVD STE 110
City WOODLAND HILLS
State CA
ZIP 91364
Phone 818 570-1670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Hospital
Lab Director AUDRA E. FORD

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