05D2158814 CLIA NUMBER - HEAVENLY HOSPICE CARE, INC

Laboratory Demographics

CLIA Number: 05D2158814

Facility Name: HEAVENLY HOSPICE CARE, INC

Facility Address:
514 COMMERCE AVE, STE G
PALMDALE, CA
ZIP 93551
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Facility Phone Number: 818 666-4015

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1699193052

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2158814
LAB Type	Hospice
Facility Name	HEAVENLY HOSPICE CARE, INC
Street	514 COMMERCE AVE, STE G
City	PALMDALE
State	CA
ZIP	93551
Phone	818 666-4015
CertificateType	4
CertificateEffectiveDate	12/6/2022
CertificateExpirationDate	12/5/2024
FacilityType	Waiver

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