03D2099690 CLIA NUMBER - Divine Hospice And Palliative Care LLC

Laboratory Demographics

CLIA Number: 03D2099690

Facility Name: Divine Hospice And Palliative Care LLC

Facility Address:
16165 N 83rd Ave Ste 200
Peoria, AZ
ZIP 85382
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Facility Phone Number: (623) 888-3016

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1104223106

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name Field Value
CLIA Number 03D2099690
LAB Type HOSPICE
Facility Name Divine Hospice And Palliative Care LLC
Street 16165 N 83rd Ave Ste 200
City Peoria
State AZ
ZIP 85382
Phone (623) 888-3016

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This page was last updated on: 4/7/2021