03D2116017 CLIA NUMBER - VILLA TEJADA LLC DBA HOLY CROSS HOSPICE

Laboratory Demographics

CLIA Number: 03D2116017

Facility Name: VILLA TEJADA LLC DBA HOLY CROSS HOSPICE

Facility Address:
6124 E BROWN RD, STE 101
MESA, AZ
ZIP 85205
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Facility Phone Number: (480) 718-5678

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1386097905

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2116017
LAB Type	HOSPICE
Facility Name	VILLA TEJADA LLC DBA HOLY CROSS HOSPICE
Street	6124 E BROWN RD, STE 101
City	MESA
State	AZ
ZIP	85205
Phone	(480) 718-5678

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