05D1086484 CLIA NUMBER - COVENANT HOSPICE

Laboratory Demographics

  • CLIA Code: 05D1086484
  • Facility Name: COVENANT HOSPICE
  • Facility Address: 7872 WALKER ST STE 240
    LA PALMA, CA
    ZIP 90623
  • Facility Phone: 714 670-7334
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DR. SAMPATH SURYADEVARA
  • NPI Number: 1346413473
  • Taxonomy: 315D00000X - Hospice, Inpatient

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CLIA Record

Field Name Field Value
CLIA Number 05D1086484
LAB Type Hospice
Facility Name COVENANT HOSPICE
Street 7872 WALKER ST STE 240
City LA PALMA
State CA
ZIP 90623
Phone 714 670-7334
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Hospice
Lab Director DR. SAMPATH SURYADEVARA

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