05D2308572 CLIA NUMBER - INTERGALACTIC HEALTHCARE INC

Laboratory Demographics

  • CLIA Code: 05D2308572
  • Facility Name: INTERGALACTIC HEALTHCARE INC
  • Facility Address: 15211 VANOWEN ST, STE 110
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 387-8871
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN A. NGUYEN
  • NPI Number: 1245671684
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2308572
LAB Type Pharmacy
Facility Name INTERGALACTIC HEALTHCARE INC
Street 15211 VANOWEN ST, STE 110
City VAN NUYS
State CA
ZIP 91405
Phone 818 387-8871
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Pharmacy
Lab Director BRIAN A. NGUYEN

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