05D2078941 CLIA NUMBER - PRIM HOSPICE CARE INC

Laboratory Demographics

  • CLIA Code: 05D2078941
  • Facility Name: PRIM HOSPICE CARE INC
  • Facility Address: 4413 RIVERSIDE DR STE E
    CHINO, CA
    ZIP 91710
  • Facility Phone: 714 395-4694
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ALI SHAHVERDIANI
  • NPI Number: 1487083705
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2078941
LAB Type Hospice
Facility Name PRIM HOSPICE CARE INC
Street 4413 RIVERSIDE DR STE E
City CHINO
State CA
ZIP 91710
Phone 714 395-4694
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Hospice
Lab Director ALI SHAHVERDIANI

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