05D2279679 CLIA NUMBER - AZALEA HOSPICE

Laboratory Demographics

CLIA Number: 05D2279679

Facility Name: AZALEA HOSPICE

Facility Address:
9778 KATELLA AVE STE 114
ANAHEIM, CA
ZIP 92804
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Facility Phone Number: 714 533-7707

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1689270688

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2279679
LAB Type	Hospice
Facility Name	AZALEA HOSPICE
Street	9778 KATELLA AVE STE 114
City	ANAHEIM
State	CA
ZIP	92804
Phone	714 533-7707
CertificateType	4
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	Waiver

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