05D2042347 CLIA NUMBER - ANGEL'S SMILE HOSPICE, INC

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Laboratory Demographics

CLIA Number: 05D2042347

Facility Name: ANGEL'S SMILE HOSPICE, INC

Facility Address:
1241 S GLENDALE AVE STE 305
GLENDALE, CA
ZIP 91205
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Facility Phone Number: 818 505-9010

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1194003277

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2042347
LAB Type	Hospice
Facility Name	ANGEL'S SMILE HOSPICE, INC
Street	1241 S GLENDALE AVE STE 305
City	GLENDALE
State	CA
ZIP	91205
Phone	818 505-9010
CertificateType	4
CertificateEffectiveDate	6/8/2022
CertificateExpirationDate	6/7/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024