05D2076087 CLIA NUMBER - EXCELCARE HOSPICE, INC

Laboratory Demographics

  • CLIA Code: 05D2076087
  • Facility Name: EXCELCARE HOSPICE, INC
  • Facility Address: 937 VIA LATA STE 200
    COLTON, CA
    ZIP 92324
  • Facility Phone: 909 300-5533
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DAVID FUKUDA
  • NPI Number: 1073935664
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2076087
LAB Type Hospice
Facility Name EXCELCARE HOSPICE, INC
Street 937 VIA LATA STE 200
City COLTON
State CA
ZIP 92324
Phone 909 300-5533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Hospice
Lab Director DAVID FUKUDA

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