03D1078221 CLIA NUMBER - CACTUS HEIGHTS HEALTHCARE LLC DBA EMBLEM HOSPICE CENTRAL

Laboratory Demographics

CLIA Number: 03D1078221

Facility Name: CACTUS HEIGHTS HEALTHCARE LLC DBA EMBLEM HOSPICE CENTRAL

Facility Address:
301 E BETHANY HOME RD, STE C-275
PHOENIX, AZ
ZIP 85051
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Facility Phone Number: 623 847-2323

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1871125849

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D1078221
LAB Type	Hospice
Facility Name	CACTUS HEIGHTS HEALTHCARE LLC DBA EMBLEM HOSPICE CENTRAL
Street	301 E BETHANY HOME RD, STE C-275
City	PHOENIX
State	AZ
ZIP	85051
Phone	623 847-2323
CertificateType	4
CertificateEffectiveDate	1/4/2024
CertificateExpirationDate	1/3/2026
FacilityType	Waiver

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