05D2079766 CLIA NUMBER - SAN ANTONIO HOSPICE, INC DBA OLYMPIA HOSPICE & PALLIATIVE CARE

Laboratory Demographics

  • CLIA Code: 05D2079766
  • Facility Name: SAN ANTONIO HOSPICE, INC DBA OLYMPIA HOSPICE & PALLIATIVE CARE
  • Facility Address: 419 W COLORADO ST, STE B
    GLENDALE, CA
    ZIP 91204
  • Facility Phone: 818 238-9999
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DR. BENYAMIN HANI ADIEP MD
  • NPI Number: 1982929774
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2079766
LAB Type Hospice
Facility Name SAN ANTONIO HOSPICE, INC DBA OLYMPIA HOSPICE & PALLIATIVE CARE
Street 419 W COLORADO ST, STE B
City GLENDALE
State CA
ZIP 91204
Phone 818 238-9999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Hospice
Lab Director DR. BENYAMIN HANI ADIEP MD

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