05D2187528 CLIA NUMBER - WGM HOSPICE CARE

Laboratory Demographics

CLIA Number: 05D2187528

Facility Name: WGM HOSPICE CARE

Facility Address:
1255 WEST COLTON AVE SUITE 529
REDLANDS, CA
ZIP 92374
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Facility Phone Number: 800 976-1014

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1053768515

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2187528
LAB Type	Hospice
Facility Name	WGM HOSPICE CARE
Street	1255 WEST COLTON AVE SUITE 529
City	REDLANDS
State	CA
ZIP	92374
Phone	800 976-1014
CertificateType	4
CertificateEffectiveDate	7/2/2022
CertificateExpirationDate	7/1/2024
FacilityType	Waiver

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