05D2308111 CLIA NUMBER - LIFE LINE HEALTH CARE SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2308111
  • Facility Name: LIFE LINE HEALTH CARE SERVICES INC
  • Facility Address: 121 W LEXINGTON DR STE 218B
    GLENDALE, CA
    ZIP 91203
  • Facility Phone: 747 441-1464
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SEVAK MINASSIAN
  • NPI Number: 1801570536
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2308111
LAB Type Home Health Agency
Facility Name LIFE LINE HEALTH CARE SERVICES INC
Street 121 W LEXINGTON DR STE 218B
City GLENDALE
State CA
ZIP 91203
Phone 747 441-1464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Home Health Agency
Lab Director SEVAK MINASSIAN

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