01D2055915 CLIA NUMBER - NEW BEACON HEALTHCARE GROUP LLC - SCOTTSBORO

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Laboratory Demographics

CLIA Number: 01D2055915

Facility Name: NEW BEACON HEALTHCARE GROUP LLC - SCOTTSBORO

Facility Address:
1602 S BROAD STREET
SCOTTSBORO, AL
ZIP 35768
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Facility Phone Number: 704 662-0416

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1588693550

Taxonomy: 163WH1000X - Registered Nurse

CLIA Record

Field Name	Field Value
CLIA Number	01D2055915
LAB Type	Hospice
Facility Name	NEW BEACON HEALTHCARE GROUP LLC - SCOTTSBORO
Street	1602 S BROAD STREET
City	SCOTTSBORO
State	AL
ZIP	35768
Phone	704 662-0416
CertificateType	4
CertificateEffectiveDate	3/19/2023
CertificateExpirationDate	3/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024