CLIA lab
CLIA 05D1039663: Lifeline Medical Laboratory Inc
N Hollywood, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1039663 belongs to Lifeline Medical Laboratory Inc in N Hollywood, CA.
Certificate of Compliance, effective October 21, 2025, expires October 20, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Compliance
- Certificate effective
- October 21, 2025
- Certificate expiration
- October 20, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 19, 2005
- Facility type
- Independent
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1039663
- Lab name
- Lifeline Medical Laboratory Inc
- Address
- 10509 Burbank Blvd, N Hollywood, CA 91601
- Phone
- (818) 579-4220
- Fax
- (818) 301-1916
Annual test volume the lab reported
- Other nonwaived tests
- 38,087
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in N Hollywood, CA
- A&g Home Health Care, IncCertificate of Waiver, Home health agency05D2159839
- Arba Home Healthcare IncCertificate of Waiver, Home health agency05D2191790
- Gods Army Wellness Home IncCertificate of Waiver, Other05D2314805
- Integrative Pediatrics and Medicine Studio CityCertificate of Waiver, Physician office05D2153682
- Lakeside Medical Organization, A Medical GRP, IncCertificate of Waiver, Physician office05D0952072
- Legacy Healing Center California, LLCCertificate of Waiver, Other05D2320430
- Legacy Healing Center California, LLCCertificate of Waiver, Other05D2320465
- Legacy Healing Center California, LLCCertificate of Waiver, Other05D2321520
- Sama Hospice, IncCertificate of Waiver, Hospice05D2172673
- Shavash Safvati MDCertificate of Waiver, Physician office05D0943646
Related
Questions
What is the CLIA number for Lifeline Medical Laboratory Inc in N Hollywood?
05D1039663, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lifeline Medical Laboratory Inc hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 05D1039663 expire?
The CMS file lists October 20, 2027 as the certificate expiration date; the certificate took effect October 21, 2025.