05D2196695 CLIA NUMBER - AGAPE HOSPICE CARE, INC

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Laboratory Demographics

CLIA Number: 05D2196695

Facility Name: AGAPE HOSPICE CARE, INC

Facility Address:
5924 EAST LOS ANGELES AVENUE SUITE L
SIMI VALLEY, CA
ZIP 93063
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Facility Phone Number: 805 422-8760

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1366082349

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2196695
LAB Type	Hospice
Facility Name	AGAPE HOSPICE CARE, INC
Street	5924 EAST LOS ANGELES AVENUE SUITE L
City	SIMI VALLEY
State	CA
ZIP	93063
Phone	805 422-8760
CertificateType	4
CertificateEffectiveDate	10/19/2022
CertificateExpirationDate	10/18/2024
FacilityType	Waiver

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