03D2167455 CLIA NUMBER - STILLWATER HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 03D2167455
  • Facility Name: STILLWATER HOSPICE LLC
  • Facility Address: 22601 N 19TH AVE STE 230
    PHOENIX, AZ
    ZIP 85027
  • Facility Phone: 602 567-9953
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JASON BREY
  • NPI Number: 1548825276
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2167455
LAB Type Hospice
Facility Name STILLWATER HOSPICE LLC
Street 22601 N 19TH AVE STE 230
City PHOENIX
State AZ
ZIP 85027
Phone 602 567-9953
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Hospice
Lab Director JASON BREY

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