05D2297840 CLIA NUMBER - EVOLVE HOME HEALTH

Laboratory Demographics

  • CLIA Code: 05D2297840
  • Facility Name: EVOLVE HOME HEALTH
  • Facility Address: 22048 SHERMAN WAY SUITE 313
    CANOGA PARK, CA
    ZIP 91303
  • Facility Phone: 310 923-4691
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SASAN SAZGAR
  • NPI Number: 1104431147
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2297840
LAB Type Home Health Agency
Facility Name EVOLVE HOME HEALTH
Street 22048 SHERMAN WAY SUITE 313
City CANOGA PARK
State CA
ZIP 91303
Phone 310 923-4691
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Home Health Agency
Lab Director SASAN SAZGAR

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