05D2078749 CLIA NUMBER - FELLOWSHIP HOSPICE SERVICES, INC.

Laboratory Demographics

  • CLIA Code: 05D2078749
  • Facility Name: FELLOWSHIP HOSPICE SERVICES, INC.
  • Facility Address: 520 N BROOKHURST ST, STE 214
    ANAHEIM, CA
    ZIP 92801
  • Facility Phone: 562 462-0044
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DOMINGO BARIENTOS
  • NPI Number: 1861818718
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2078749
LAB Type Hospice
Facility Name FELLOWSHIP HOSPICE SERVICES, INC.
Street 520 N BROOKHURST ST, STE 214
City ANAHEIM
State CA
ZIP 92801
Phone 562 462-0044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Hospice
Lab Director DOMINGO BARIENTOS

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