05D2203465 CLIA NUMBER - ANGENIDA HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 05D2203465
  • Facility Name: ANGENIDA HOSPICE LLC
  • Facility Address: 14081 YORBA STREET SUITE 201
    TUSTIN, CA
    ZIP 92780
  • Facility Phone: 714 442-3853
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SIEGHART PONHOLD
  • NPI Number: 1669008934
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2203465
LAB Type Hospice
Facility Name ANGENIDA HOSPICE LLC
Street 14081 YORBA STREET SUITE 201
City TUSTIN
State CA
ZIP 92780
Phone 714 442-3853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Hospice
Lab Director SIEGHART PONHOLD

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