05D2305801 CLIA NUMBER - ELITE HOSPICE & PALLIATIVE CARE INC

Laboratory Demographics

  • CLIA Code: 05D2305801
  • Facility Name: ELITE HOSPICE & PALLIATIVE CARE INC
  • Facility Address: 8400 MAPLE PL, STE 109
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 481-0998
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SHANTHARAM PAI
  • NPI Number: 1073100244
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2305801
LAB Type Hospice
Facility Name ELITE HOSPICE & PALLIATIVE CARE INC
Street 8400 MAPLE PL, STE 109
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 481-0998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Hospice
Lab Director SHANTHARAM PAI

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