03D2099690 CLIA NUMBER - DIVINE HOSPICE AND PALLIATIVE CARE LLC

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Laboratory Demographics

CLIA Number: 03D2099690

Facility Name: DIVINE HOSPICE AND PALLIATIVE CARE LLC

Facility Address:
18185 N 83RD AVE STE 203
GLENDALE, AZ
ZIP 85308
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Facility Phone Number: (623) 262-4443

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	18185 N 83RD AVE STE 203
City	GLENDALE
State	AZ
ZIP	85308
Phone	(623) 262-4443

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This page was last updated on: 5/11/2023