1. Home
  2. Directory
  3. California
  4. Granada Hills
  5. Clinic Center
  6. NPI Profile

PRIME VALLEY MEDICAL CENTER INC
NPI 1427862572
Clinic/Center - Health Service in Granada Hills, CA

Active since February 06, 2025CLIA 05D2343046 · Waiver
17541 CHATSWORTH ST, GRANADA HILLS, CA 91344(909) 217-8633 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prime Valley Medical Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME VALLEY MEDICAL CENTER INC (NPI 1427862572) is a healthcare organization registered as a health service in Granada Hills, California and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through April 29, 2028 and lists King Nino Diaz, Np, as its authorized official.

NPPES Registry Identity

NPI1427862572
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NamePRIME VALLEY MEDICAL CENTER INC
Location Address17541 CHATSWORTH STGranada Hills, CA 91344-5720
Mailing Address17541 Chatsworth StGranada Hills, CA 91344-5720
Phone(909) 217-8633
Organization SubpartNo
Authorized OfficialKing Nino DiazNp · (909) 217-8633
Enumeration DateFebruary 6, 2025
NPPES CertifiedFebruary 6, 2025
✔ NPI 1427862572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
17541 CHATSWORTH ST, Granada Hills, CA 91344
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2343046

Prime Valley Medical Center Inc · Granada Hills, CA
Active · expires Apr 29, 2028
CLIA Number05D2343046
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2026
Certificate Expiration DateApril 29, 2028
Laboratory DirectorKohli Gurmander
Laboratory Phone(818) 617-9799
Laboratory LocationPrime Valley Medical Center Inc17541 Chatsworth St, Granada Hills, CA 91344
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is PRIME VALLEY MEDICAL CENTER INC's NPI number?

The NPI number assigned to this healthcare provider is 1427862572, enumerated as an "organization" on February 06, 2025.

Where is the provider located?

The provider is located at 17541 CHATSWORTH ST GRANADA HILLS, CA 91344 and the phone number is (909) 217-8633.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.