05D2311889 CLIA NUMBER - FRESH START HOSPICE CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2311889
  • Facility Name: FRESH START HOSPICE CARE, INC
  • Facility Address: 11131 VANOWEN ST SUITE B
    NORTH HOLLYWOOD, CA
    ZIP 91605
  • Facility Phone: 818 637-0093
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ABDUL R. KHAN
  • NPI Number: 1417564006
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2311889
LAB Type Hospice
Facility Name FRESH START HOSPICE CARE, INC
Street 11131 VANOWEN ST SUITE B
City NORTH HOLLYWOOD
State CA
ZIP 91605
Phone 818 637-0093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Hospice
Lab Director ABDUL R. KHAN

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