05D2323774 CLIA NUMBER - HOLISTICAL PRIMARY CAREA AND ADVANCED NURSING SERVICES, INC

Laboratory Demographics

  • CLIA Code: 05D2323774
  • Facility Name: HOLISTICAL PRIMARY CAREA AND ADVANCED NURSING SERVICES, INC
  • Facility Address: 6911 TOPANGA CANYON BLVD, SUITE 206
    CANOGA PARK, CA
    ZIP 91303
  • Facility Phone: 323 362-7767
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BORIS VAISMAN
  • NPI Number: 1821806233
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 05D2323774
LAB Type Practitioner Other
Facility Name HOLISTICAL PRIMARY CAREA AND ADVANCED NURSING SERVICES, INC
Street 6911 TOPANGA CANYON BLVD, SUITE 206
City CANOGA PARK
State CA
ZIP 91303
Phone 323 362-7767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Practitioner Other
Lab Director BORIS VAISMAN

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