03D2121556 CLIA NUMBER - RIVER VALLEY HOSPICE

Laboratory Demographics

  • Code: 03D2121556
  • Facility Name: RIVER VALLEY HOSPICE
  • Facility Address: 2649 HWY 95, UNIT G
    BULLHEAD CITY, AZ
    ZIP 86442
  • Facility Phone: 928 683-4041
  • Facility Type: Hospice
  • Facility Type: Waiver
  • NPI Number: 1629452768
  • Taxonomy: 251G00000X - Hospice Care, Community Based
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CLIA Record

Field Name Field Value
CLIA Number 03D2121556
LAB Type Hospice
Facility Name RIVER VALLEY HOSPICE
Street 2649 HWY 95, UNIT G
City BULLHEAD CITY
State AZ
ZIP 86442
Phone 928 683-4041
Certificate Type 4
Certificate Effective Date 11/8/2022
Certificate Expiration Date 11/7/2024
Facility Type Waiver

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