05D2210086 CLIA NUMBER - ALLAY 4 HOSPICE, INC

Laboratory Demographics

  • CLIA Code: 05D2210086
  • Facility Name: ALLAY 4 HOSPICE, INC
  • Facility Address: 14350 CIVIC DR SUITE 130
    VICTORVILLE, CA
    ZIP 92392
  • Facility Phone: 909 493-2197
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ABDUL R. KHAN
  • NPI Number: 1386261568
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2210086
LAB Type Hospice
Facility Name ALLAY 4 HOSPICE, INC
Street 14350 CIVIC DR SUITE 130
City VICTORVILLE
State CA
ZIP 92392
Phone 909 493-2197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Hospice
Lab Director ABDUL R. KHAN

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