05D2293804 CLIA NUMBER - AVIVA HOSPICE, INC.

Laboratory Demographics

  • CLIA Code: 05D2293804
  • Facility Name: AVIVA HOSPICE, INC.
  • Facility Address: 1200 CALIFORNIA STREET, STE 130
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 909 284-5600
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: PETER MATTAR
  • NPI Number: 1043826811
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2293804
LAB Type Hospice
Facility Name AVIVA HOSPICE, INC.
Street 1200 CALIFORNIA STREET, STE 130
City REDLANDS
State CA
ZIP 92374
Phone 909 284-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Hospice
Lab Director PETER MATTAR

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