05D2122545 CLIA NUMBER - BRISTOL HOSPICE- INLAND EMPIRE LLC

Laboratory Demographics

CLIA Number: 05D2122545

Facility Name: BRISTOL HOSPICE- INLAND EMPIRE LLC

Facility Address:
6296 RIVER CREST DR STE L
RIVERSIDE, CA
ZIP 92507
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Facility Phone Number: 951 308-6000

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1043683170

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2122545
LAB Type	Hospice
Facility Name	BRISTOL HOSPICE- INLAND EMPIRE LLC
Street	6296 RIVER CREST DR STE L
City	RIVERSIDE
State	CA
ZIP	92507
Phone	951 308-6000
CertificateType	4
CertificateEffectiveDate	11/30/2022
CertificateExpirationDate	11/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024