05D2091640 CLIA NUMBER - MISSION HOSPICE OF THE INLAND EMPIRE

Laboratory Demographics

  • CLIA Code: 05D2091640
  • Facility Name: MISSION HOSPICE OF THE INLAND EMPIRE
  • Facility Address: 818 N MOUNTAIN AVE STE 104
    UPLAND, CA
    ZIP 91786
  • Facility Phone: 909 981-3000
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JAE LEE, MD
  • NPI Number: 1700280328
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2091640
LAB Type Hospice
Facility Name MISSION HOSPICE OF THE INLAND EMPIRE
Street 818 N MOUNTAIN AVE STE 104
City UPLAND
State CA
ZIP 91786
Phone 909 981-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Hospice
Lab Director JAE LEE, MD

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