05D2084672 CLIA NUMBER - BLENDSHIP, INC

Laboratory Demographics

  • CLIA Code: 05D2084672
  • Facility Name: BLENDSHIP, INC
  • Facility Address: 876 N. MOUNTAIN AVENUE SUITE 200F
    UPLAND, CA
    ZIP 91786
  • Facility Phone: 909 950-9400
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: HABIB M. BASHOURA, MD
  • NPI Number: 1144649609
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2084672
LAB Type Hospice
Facility Name BLENDSHIP, INC
Street 876 N. MOUNTAIN AVENUE SUITE 200F
City UPLAND
State CA
ZIP 91786
Phone 909 950-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Hospice
Lab Director HABIB M. BASHOURA, MD

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