05D2305766 CLIA NUMBER - ETERNAL GRACE HOSPICE, INC.

Laboratory Demographics

  • CLIA Code: 05D2305766
  • Facility Name: ETERNAL GRACE HOSPICE, INC.
  • Facility Address: 9613 ARROW RTE STE B
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 818 616-6260
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: HUNG M. NGUYEN
  • NPI Number: 1003378142
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2305766
LAB Type Hospice
Facility Name ETERNAL GRACE HOSPICE, INC.
Street 9613 ARROW RTE STE B
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 818 616-6260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Hospice
Lab Director HUNG M. NGUYEN

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