03D2099690 CLIA NUMBER - DIVINE HOSPICE AND PALLIATIVE CARE LLC

Laboratory Demographics

  • CLIA Code: 03D2099690
  • Facility Name: DIVINE HOSPICE AND PALLIATIVE CARE LLC
  • Facility Address: 18185 N 83RD AVE STE 203
    GLENDALE, AZ
    ZIP 85308
  • Facility Phone: 623 262-4443
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: RIKESH DESAI
  • NPI Number: 1104223106
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2023
Certificate Expiration Date 7/29/2025
Facility Type Hospice
Lab Director RIKESH DESAI

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This page was last updated on: 3/20/2025