01D1020277 CLIA NUMBER - WIREGRASS HOSPICE LLC DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 01D1020277
  • Facility Name: WIREGRASS HOSPICE LLC DBA GENTIVA
  • Facility Address: 5000 BRADFORD DRIVE NW STE 3A
    HUNTSVILLE, AL
    ZIP 35805
  • Facility Phone: 704 664-2876
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE BEASLEY
  • NPI Number: 1770519324
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 01D1020277
LAB Type Hospice
Facility Name WIREGRASS HOSPICE LLC DBA GENTIVA
Street 5000 BRADFORD DRIVE NW STE 3A
City HUNTSVILLE
State AL
ZIP 35805
Phone 704 664-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Hospice
Lab Director SELECE BEASLEY

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