05D2304775 CLIA NUMBER - WILLOW HOSPICE CARE INC

Laboratory Demographics

  • CLIA Code: 05D2304775
  • Facility Name: WILLOW HOSPICE CARE INC
  • Facility Address: 14545 VICTORY BLVD STE 503
    VAN NUYS, CA
    ZIP 91411
  • Facility Phone: 818 574-6221
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: VICRUMDEEP S. TUNG
  • NPI Number: 1932691813
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2304775
LAB Type Hospice
Facility Name WILLOW HOSPICE CARE INC
Street 14545 VICTORY BLVD STE 503
City VAN NUYS
State CA
ZIP 91411
Phone 818 574-6221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Hospice
Lab Director VICRUMDEEP S. TUNG

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