05D2147790 CLIA NUMBER - CENTRAL HOSPICE INC

Laboratory Demographics

CLIA Number: 05D2147790

Facility Name: CENTRAL HOSPICE INC

Facility Address:
1110 SONORA AVE, #212
GLENDALE, CA
ZIP 91201
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Facility Phone Number: 818 951-8400

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1326403163

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2147790
LAB Type	Hospice
Facility Name	CENTRAL HOSPICE INC
Street	1110 SONORA AVE, #212
City	GLENDALE
State	CA
ZIP	91201
Phone	818 951-8400
CertificateType	4
CertificateEffectiveDate	4/26/2022
CertificateExpirationDate	4/25/2024
FacilityType	Waiver

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