03D2142318 CLIA NUMBER - LAVENDER HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 03D2142318
  • Facility Name: LAVENDER HOSPICE LLC
  • Facility Address: 20815 N 25TH PLACE, SUITE A106
    PHOENIX, AZ
    ZIP 85050
  • Facility Phone: 602 283-3663
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROSELAVENDER RICHARDS
  • NPI Number: 1982117305
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2142318
LAB Type Hospice
Facility Name LAVENDER HOSPICE LLC
Street 20815 N 25TH PLACE, SUITE A106
City PHOENIX
State AZ
ZIP 85050
Phone 602 283-3663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Hospice
Lab Director ROSELAVENDER RICHARDS

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This page was last updated on: 9/29/2025