05D2036471 CLIA NUMBER - ANGELS ON EARTH HOSPICE

Laboratory Demographics

  • CLIA Code: 05D2036471
  • Facility Name: ANGELS ON EARTH HOSPICE
  • Facility Address: 4959 PALO VERDE ST. # 202-A
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 626-8802
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROBERT E. LADINES
  • NPI Number: 1093082281
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2036471
LAB Type Hospice
Facility Name ANGELS ON EARTH HOSPICE
Street 4959 PALO VERDE ST. # 202-A
City MONTCLAIR
State CA
ZIP 91763
Phone 909 626-8802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Hospice
Lab Director ROBERT E. LADINES

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