05D2178246 CLIA NUMBER - JOURNEY HOSPICE CARE, INC

Laboratory Demographics

CLIA Number: 05D2178246

Facility Name: JOURNEY HOSPICE CARE, INC

Facility Address:
600 N MOUNTAIN AVE SUITE C - 203
UPLAND, CA
ZIP 91786
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Facility Phone Number: 909 252-7073

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1255862389

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2178246
LAB Type	Hospice
Facility Name	JOURNEY HOSPICE CARE, INC
Street	600 N MOUNTAIN AVE SUITE C - 203
City	UPLAND
State	CA
ZIP	91786
Phone	909 252-7073
CertificateType	4
CertificateEffectiveDate	1/29/2024
CertificateExpirationDate	1/28/2026
FacilityType	Waiver

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