05D2192572 CLIA NUMBER - CARDINAL HOSPICE AND PALLIATIVE CARE

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Laboratory Demographics

CLIA Number: 05D2192572

Facility Name: CARDINAL HOSPICE AND PALLIATIVE CARE

Facility Address:
500 N PALM AVE
ONTARIO, CA
ZIP 91762
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Facility Phone Number: 909 395-9676

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1972129641

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2192572
LAB Type	Hospice
Facility Name	CARDINAL HOSPICE AND PALLIATIVE CARE
Street	500 N PALM AVE
City	ONTARIO
State	CA
ZIP	91762
Phone	909 395-9676
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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