05D2012653 CLIA NUMBER - PRUDENTIAL HOSPICE CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2012653
  • Facility Name: PRUDENTIAL HOSPICE CARE, INC
  • Facility Address: 13047 ARTESIA BLVD STE C200
    CERRITOS, CA
    ZIP 90703
  • Facility Phone: 562 924-1555
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: STEVEN LAKE
  • NPI Number: 1720316805
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2012653
LAB Type Hospice
Facility Name PRUDENTIAL HOSPICE CARE, INC
Street 13047 ARTESIA BLVD STE C200
City CERRITOS
State CA
ZIP 90703
Phone 562 924-1555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Hospice
Lab Director STEVEN LAKE

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