05D0903955 CLIA NUMBER - AGAPE HOME CARE INC

Laboratory Demographics

  • CLIA Code: 05D0903955
  • Facility Name: AGAPE HOME CARE INC
  • Facility Address: 99 N SAN ANTONIO AVE
    UPLAND, CA
    ZIP 91786
  • Facility Phone: 909 949-7666
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MOGASBE ABDELSALAM
  • NPI Number: 1689651176
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0903955
LAB Type Home Health Agency
Facility Name AGAPE HOME CARE INC
Street 99 N SAN ANTONIO AVE
City UPLAND
State CA
ZIP 91786
Phone 909 949-7666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Home Health Agency
Lab Director MOGASBE ABDELSALAM

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