05D2186602 CLIA NUMBER - JEM CARE HOSPICE

Laboratory Demographics

  • CLIA Code: 05D2186602
  • Facility Name: JEM CARE HOSPICE
  • Facility Address: 4959 PALO VERDE ST STE 206A-3
    MONTCLAIR, CA
    ZIP 91763
  • Facility Phone: 909 236-5579
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: HUSSAIN RIZWANA
  • NPI Number: 1760022016
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2186602
LAB Type Hospice
Facility Name JEM CARE HOSPICE
Street 4959 PALO VERDE ST STE 206A-3
City MONTCLAIR
State CA
ZIP 91763
Phone 909 236-5579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Hospice
Lab Director HUSSAIN RIZWANA

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