05D2107459 CLIA NUMBER - AFFECTIVE HOSPICE CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2107459
  • Facility Name: AFFECTIVE HOSPICE CARE, INC
  • Facility Address: 5050 PALO VERDE ST STE 208
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 962-7488
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MICHAEL CHAI, MD
  • NPI Number: 1548645302
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2107459
LAB Type Hospice
Facility Name AFFECTIVE HOSPICE CARE, INC
Street 5050 PALO VERDE ST STE 208
City MONTCLAIR
State CA
ZIP 91763
Phone 909 962-7488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Hospice
Lab Director MICHAEL CHAI, MD

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