05D2193541 CLIA NUMBER - ADYA HOSPICE & PALLIATIVE CARE LLC

Laboratory Demographics

  • CLIA Code: 05D2193541
  • Facility Name: ADYA HOSPICE & PALLIATIVE CARE LLC
  • Facility Address: 1652 W TEXAS ST STE 207
    FAIRFIELD, CA
    ZIP 94533
  • Facility Phone: 707 200-2989
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: HERMENEGILDO ANGELES
  • NPI Number: 1891327573
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2193541
LAB Type Hospice
Facility Name ADYA HOSPICE & PALLIATIVE CARE LLC
Street 1652 W TEXAS ST STE 207
City FAIRFIELD
State CA
ZIP 94533
Phone 707 200-2989
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Hospice
Lab Director HERMENEGILDO ANGELES

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