05D2055672 CLIA NUMBER - WELLHOUSE CARE, INC.

Laboratory Demographics

  • CLIA Code: 05D2055672
  • Facility Name: WELLHOUSE CARE, INC.
  • Facility Address: 11354 MOUNTIAN VIEW AVE., STE. D
    LOMA LINDA, CA
    ZIP 92354
  • Facility Phone: 909 796-4270
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SHUJA AYOUBY
  • NPI Number: 1548535370
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2055672
LAB Type Hospice
Facility Name WELLHOUSE CARE, INC.
Street 11354 MOUNTIAN VIEW AVE., STE. D
City LOMA LINDA
State CA
ZIP 92354
Phone 909 796-4270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Hospice
Lab Director SHUJA AYOUBY

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