03D2104859 CLIA NUMBER - HOSPICE AT HOME OF ARIZONA

Laboratory Demographics

CLIA Number: 03D2104859

Facility Name: HOSPICE AT HOME OF ARIZONA

Facility Address:
2500 S POWER RD STE 125
MESA, AZ
ZIP 85209
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Facility Phone Number: (480) 478-0643

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1376986463

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2104859
LAB Type	HOSPICE
Facility Name	HOSPICE AT HOME OF ARIZONA
Street	2500 S POWER RD STE 125
City	MESA
State	AZ
ZIP	85209
Phone	(480) 478-0643

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