05D2090497 CLIA NUMBER - ALLIED CARE HOSPICE, INC.

Laboratory Demographics

  • CLIA Code: 05D2090497
  • Facility Name: ALLIED CARE HOSPICE, INC.
  • Facility Address: 12362 BEACH BLVD, #26
    STANTON, CA
    ZIP 90680
  • Facility Phone: 909 989-6246
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DANTE BANTA
  • NPI Number: 1508278755
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2090497
LAB Type Hospice
Facility Name ALLIED CARE HOSPICE, INC.
Street 12362 BEACH BLVD, #26
City STANTON
State CA
ZIP 90680
Phone 909 989-6246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Hospice
Lab Director DANTE BANTA

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