05D2161543 CLIA NUMBER - INTRA CARE HOSPICE, INC

Laboratory Demographics

CLIA Number: 05D2161543

Facility Name: INTRA CARE HOSPICE, INC

Facility Address:
3251 W 6TH STREET, SUITE 418
LOS ANGELES, CA
ZIP 90020
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Facility Phone Number: 213 385-5301

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1699135251

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2161543
LAB Type	Hospice
Facility Name	INTRA CARE HOSPICE, INC
Street	3251 W 6TH STREET, SUITE 418
City	LOS ANGELES
State	CA
ZIP	90020
Phone	213 385-5301
CertificateType	4
CertificateEffectiveDate	2/5/2023
CertificateExpirationDate	2/4/2025
FacilityType	Waiver

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