05D2193680 CLIA NUMBER - WEST COAST HEALTH CARE

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Laboratory Demographics

CLIA Number: 05D2193680

Facility Name: WEST COAST HEALTH CARE

Facility Address:
29222 RANCHO VIEJO ROAD SUITE 102
SAN JUAN CAPISTRANO, CA
ZIP 92675
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Facility Phone Number: 949 270-3770

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1053651372

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2193680
LAB Type	Hospice
Facility Name	WEST COAST HEALTH CARE
Street	29222 RANCHO VIEJO ROAD SUITE 102
City	SAN JUAN CAPISTRANO
State	CA
ZIP	92675
Phone	949 270-3770
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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