05D2067482 CLIA NUMBER - EQUANIMITY HOSPICE AND PALLIATIVE CARE INC

Laboratory Demographics

  • CLIA Code: 05D2067482
  • Facility Name: EQUANIMITY HOSPICE AND PALLIATIVE CARE INC
  • Facility Address: 22365 BARTON RD STE 100
    GRAND TERRACE, CA
    ZIP 92313
  • Facility Phone: 909 800-3972
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: GEORGE A. PONCE
  • NPI Number: 1780019612
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2067482
LAB Type Hospice
Facility Name EQUANIMITY HOSPICE AND PALLIATIVE CARE INC
Street 22365 BARTON RD STE 100
City GRAND TERRACE
State CA
ZIP 92313
Phone 909 800-3972
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Hospice
Lab Director GEORGE A. PONCE

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