05D2297189 CLIA NUMBER - COMMUNITY CARE HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2297189
  • Facility Name: COMMUNITY CARE HOSPICE INC
  • Facility Address: 13529 1/2 VICTORY BLVD
    VAN NUYS, CA
    ZIP 91401
  • Facility Phone: 818 616-4956
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: LIONEL L. NELSON
  • NPI Number: 1285192690
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2297189
LAB Type Hospice
Facility Name COMMUNITY CARE HOSPICE INC
Street 13529 1/2 VICTORY BLVD
City VAN NUYS
State CA
ZIP 91401
Phone 818 616-4956
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Hospice
Lab Director LIONEL L. NELSON

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