05D2112541 CLIA NUMBER - FIRST SOLUTION HOSPICE CARE INC.

Laboratory Demographics

  • CLIA Code: 05D2112541
  • Facility Name: FIRST SOLUTION HOSPICE CARE INC.
  • Facility Address: 4959 PALO VERDE ST, STE 205B
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 675-7927
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROY H. JACKSON
  • NPI Number: 1063879484
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2112541
LAB Type Hospice
Facility Name FIRST SOLUTION HOSPICE CARE INC.
Street 4959 PALO VERDE ST, STE 205B
City MONTCLAIR
State CA
ZIP 91763
Phone 909 675-7927
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2023
Certificate Expiration Date 10/2/2025
Facility Type Hospice
Lab Director ROY H. JACKSON

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