05D2087596 CLIA NUMBER - GRAND TERRACE HOSPICE

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Laboratory Demographics

CLIA Number: 05D2087596

Facility Name: GRAND TERRACE HOSPICE

Facility Address:
22737 BARTON RD STE 11
GRAND TERRACE, CA
ZIP 92313
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Facility Phone Number: (323) 440-4647

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1659791721

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2087596
LAB Type	HOSPICE
Facility Name	GRAND TERRACE HOSPICE
Street	22737 BARTON RD STE 11
City	GRAND TERRACE
State	CA
ZIP	92313
Phone	(323) 440-4647

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This page was last updated on: 5/11/2023