05D2081586 CLIA NUMBER - GRACEFUL CARE HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2081586
  • Facility Name: GRACEFUL CARE HOSPICE INC
  • Facility Address: 2082 NEWBURY RD STE 12
    NEWBURY PARK, CA
    ZIP 91320
  • Facility Phone: 805 499-3700
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: RICHARD X. NGUYEN
  • NPI Number: 1467866772
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2081586
LAB Type Hospice
Facility Name GRACEFUL CARE HOSPICE INC
Street 2082 NEWBURY RD STE 12
City NEWBURY PARK
State CA
ZIP 91320
Phone 805 499-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Hospice
Lab Director RICHARD X. NGUYEN

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