03D2107270 CLIA NUMBER - HOSPICE OF HOPE LLC

Laboratory Demographics

CLIA Number: 03D2107270

Facility Name: HOSPICE OF HOPE LLC

Facility Address:
17505 N 79TH AVE STE 313
GLENDALE, AZ
ZIP 85308
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Facility Phone Number: 623 399-6910

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1497263891

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2107270
LAB Type	Hospice
Facility Name	HOSPICE OF HOPE LLC
Street	17505 N 79TH AVE STE 313
City	GLENDALE
State	AZ
ZIP	85308
Phone	623 399-6910
CertificateType	4
CertificateEffectiveDate	1/11/2024
CertificateExpirationDate	1/10/2026
FacilityType	Waiver

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