05D2165535 CLIA NUMBER - APOLLO QUEST DBA SHANGRILA HOSPICE

Laboratory Demographics

CLIA Number: 05D2165535

Facility Name: APOLLO QUEST DBA SHANGRILA HOSPICE

Facility Address:
401 N BROOKHURST ST STE 114
ANAHEIM, CA
ZIP 92801
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Facility Phone Number: 714 603-7209

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1922515246

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2165535
LAB Type	Hospice
Facility Name	APOLLO QUEST DBA SHANGRILA HOSPICE
Street	401 N BROOKHURST ST STE 114
City	ANAHEIM
State	CA
ZIP	92801
Phone	714 603-7209
CertificateType	4
CertificateEffectiveDate	8/7/2023
CertificateExpirationDate	8/6/2025
FacilityType	Waiver

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