05D2070091 CLIA NUMBER - EXCELLENCE HOSPICE PROVIDERS, INC.

Laboratory Demographics

  • CLIA Code: 05D2070091
  • Facility Name: EXCELLENCE HOSPICE PROVIDERS, INC.
  • Facility Address: 11760 CENTRAL AVE STE 201
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 590-0348
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: THAI NGUYEN
  • NPI Number: 1649614637
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2070091
LAB Type Hospice
Facility Name EXCELLENCE HOSPICE PROVIDERS, INC.
Street 11760 CENTRAL AVE STE 201
City CHINO
State CA
ZIP 91710
Phone 909 590-0348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Hospice
Lab Director THAI NGUYEN

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