05D2058626 CLIA NUMBER - Charter Hospice Inc

Laboratory Demographics

CLIA Number: 05D2058626

Facility Name: Charter Hospice Inc

Facility Address:
1012 E. Cooley Drive, Ste. G,
Colton, CA
ZIP 92324
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Facility Phone Number: (909) 825-2969

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1689716797

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name Field Value
CLIA Number 05D2058626
LAB Type HOSPICE
Facility Name Charter Hospice Inc
Street 1012 E. Cooley Drive, Ste. G,
City Colton
State CA
ZIP 92324
Phone 9098252969

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This page was last updated on: 5/19/2019