05D2079515 CLIA NUMBER - ADVANCE HOSPICE SERVICES INC

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Laboratory Demographics

CLIA Number: 05D2079515

Facility Name: ADVANCE HOSPICE SERVICES INC

Facility Address:
3400 INLAND EMPIRE BLVD, STE 100
ONTARIO, CA
ZIP 91764
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Facility Phone Number: 909 466-1000

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1306265863

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2079515
LAB Type	Hospice
Facility Name	ADVANCE HOSPICE SERVICES INC
Street	3400 INLAND EMPIRE BLVD, STE 100
City	ONTARIO
State	CA
ZIP	91764
Phone	909 466-1000
CertificateType	4
CertificateEffectiveDate	6/17/2022
CertificateExpirationDate	6/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024