05D2192387 CLIA NUMBER - CELESTIAL HOSPICE INC

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Laboratory Demographics

CLIA Number: 05D2192387

Facility Name: CELESTIAL HOSPICE INC

Facility Address:
2910 INLAND EMPIRE BLVD SUITE 116
ONTARIO, CA
ZIP 91764
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Facility Phone Number: 951 397-3336

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1538576731

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2192387
LAB Type	Hospice
Facility Name	CELESTIAL HOSPICE INC
Street	2910 INLAND EMPIRE BLVD SUITE 116
City	ONTARIO
State	CA
ZIP	91764
Phone	951 397-3336
CertificateType	4
CertificateEffectiveDate	9/9/2022
CertificateExpirationDate	9/8/2024
FacilityType	Waiver

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