05D2316907 CLIA NUMBER - TOTAL HEALTH CARE NETWORK INC

Laboratory Demographics

  • CLIA Code: 05D2316907
  • Facility Name: TOTAL HEALTH CARE NETWORK INC
  • Facility Address: 1101 N PACIFIC AVE STE 104
    GLENDALE, CA
    ZIP 91202
  • Facility Phone: 818 552-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON GROOMER
  • NPI Number: 1003284597
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2316907
LAB Type Physician Office
Facility Name TOTAL HEALTH CARE NETWORK INC
Street 1101 N PACIFIC AVE STE 104
City GLENDALE
State CA
ZIP 91202
Phone 818 552-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director JASON GROOMER

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