05D2240631 CLIA NUMBER - GREEN RIVER HOSPICE

Laboratory Demographics

  • CLIA Code: 05D2240631
  • Facility Name: GREEN RIVER HOSPICE
  • Facility Address: 10568 MAGNOLIA AVE SUITE #225
    ANAHEIM, CA
    ZIP 92804
  • Facility Phone: 626 736-5579
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: AMARISH PRADHAN
  • NPI Number: 1144868746
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2240631
LAB Type Hospice
Facility Name GREEN RIVER HOSPICE
Street 10568 MAGNOLIA AVE SUITE #225
City ANAHEIM
State CA
ZIP 92804
Phone 626 736-5579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Hospice
Lab Director AMARISH PRADHAN

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