05D2096625 CLIA NUMBER - AGAPE GROUP, INC

Laboratory Demographics

  • CLIA Code: 05D2096625
  • Facility Name: AGAPE GROUP, INC
  • Facility Address: 2930 INLAND EMPIRE BOULEVARD, SUITE 115
    ONTARIO, CA
    ZIP 91764
  • Facility Phone: 951 279-4500
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: HERMILITO VILLAR
  • NPI Number: 1487051348
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2096625
LAB Type Hospice
Facility Name AGAPE GROUP, INC
Street 2930 INLAND EMPIRE BOULEVARD, SUITE 115
City ONTARIO
State CA
ZIP 91764
Phone 951 279-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2025
Certificate Expiration Date 5/27/2027
Facility Type Hospice
Lab Director HERMILITO VILLAR

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