05D2105033 CLIA NUMBER - SUPREME HOSPICE AND PALLIATIVE CARE

Laboratory Demographics

  • CLIA Code: 05D2105033
  • Facility Name: SUPREME HOSPICE AND PALLIATIVE CARE
  • Facility Address: 28312 CONSTELLATION RD STE B
    VALENCIA, CA
    ZIP 91355
  • Facility Phone: 661 388-4328
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SABITA BALLA MD
  • NPI Number: 1700336211
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2105033
LAB Type Hospice
Facility Name SUPREME HOSPICE AND PALLIATIVE CARE
Street 28312 CONSTELLATION RD STE B
City VALENCIA
State CA
ZIP 91355
Phone 661 388-4328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Hospice
Lab Director SABITA BALLA MD

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