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
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 4807185678

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This page was last updated on: 5/19/2019