05D2301228 CLIA NUMBER - PROACTIVE HOSPICE INC

Laboratory Demographics

  • CLIA Code: 05D2301228
  • Facility Name: PROACTIVE HOSPICE INC
  • Facility Address: 2777 PACIFIC AVE STE L1
    LONG BEACH, CA
    ZIP 90806
  • Facility Phone: 562 317-8797
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ANDREAS SUBADYA
  • NPI Number: 1225635576
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2301228
LAB Type Hospice
Facility Name PROACTIVE HOSPICE INC
Street 2777 PACIFIC AVE STE L1
City LONG BEACH
State CA
ZIP 90806
Phone 562 317-8797
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Hospice
Lab Director ANDREAS SUBADYA

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