05D2295167 CLIA NUMBER - VITA HOME HEATLH SERVICES

Laboratory Demographics

  • CLIA Code: 05D2295167
  • Facility Name: VITA HOME HEATLH SERVICES
  • Facility Address: 24404 VERMONT AVE SUITE 309
    HARBOR CITY, CA
    ZIP 90710
  • Facility Phone: 323 451-7110
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: EDWARD N. OPOKU
  • NPI Number: 1639637200
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2295167
LAB Type Home Health Agency
Facility Name VITA HOME HEATLH SERVICES
Street 24404 VERMONT AVE SUITE 309
City HARBOR CITY
State CA
ZIP 90710
Phone 323 451-7110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Home Health Agency
Lab Director EDWARD N. OPOKU

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This page was last updated on: 3/20/2025