05D2066983 CLIA NUMBER - ANTHEM HOSPICE PROVIDERS, INC.

Laboratory Demographics

  • CLIA Code: 05D2066983
  • Facility Name: ANTHEM HOSPICE PROVIDERS, INC.
  • Facility Address: 850 S VIA LATA STE 118
    COLTON, CA
    ZIP 92324
  • Facility Phone: 909 533-4553
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: EFREN A. RILLO
  • NPI Number: 1366157026
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2066983
LAB Type Hospice
Facility Name ANTHEM HOSPICE PROVIDERS, INC.
Street 850 S VIA LATA STE 118
City COLTON
State CA
ZIP 92324
Phone 909 533-4553
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Hospice
Lab Director EFREN A. RILLO

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