05D2182740 CLIA NUMBER - CUSTOMCARE HOSPICE SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2182740
  • Facility Name: CUSTOMCARE HOSPICE SERVICES INC
  • Facility Address: 8837 ELK GROVE BLVD ST B
    ELK GROVE, CA
    ZIP 95759
  • Facility Phone: 916 714-1155
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROBERT TAYOR
  • NPI Number: 1821410655
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2182740
LAB Type Hospice
Facility Name CUSTOMCARE HOSPICE SERVICES INC
Street 8837 ELK GROVE BLVD ST B
City ELK GROVE
State CA
ZIP 95759
Phone 916 714-1155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Hospice
Lab Director ROBERT TAYOR

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This page was last updated on: 9/29/2025