05D2222524 CLIA NUMBER - GLORY HEALTH NETWOR DBA GLORY HOSPICE

Laboratory Demographics

  • CLIA Code: 05D2222524
  • Facility Name: GLORY HEALTH NETWOR DBA GLORY HOSPICE
  • Facility Address: 410 SOUTH MELROSE DRIVE SUITE 222
    VISTA, CA
    ZIP 92081
  • Facility Phone: 760 571-7912
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JACOB FLORES
  • NPI Number: 1538767694
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2222524
LAB Type Hospice
Facility Name GLORY HEALTH NETWOR DBA GLORY HOSPICE
Street 410 SOUTH MELROSE DRIVE SUITE 222
City VISTA
State CA
ZIP 92081
Phone 760 571-7912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2023
Certificate Expiration Date 4/28/2025
Facility Type Hospice
Lab Director JACOB FLORES

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This page was last updated on: 3/20/2025