03D2177116 CLIA NUMBER - ASSISTEO NORTH HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 03D2177116
  • Facility Name: ASSISTEO NORTH HOSPICE, LLC
  • Facility Address: 919 12TH PLACE STE 6
    PRESCOTT, AZ
    ZIP 86305
  • Facility Phone: 602 820-8094
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: TERI ELLERBE
  • NPI Number: 1598304248
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2177116
LAB Type Hospice
Facility Name ASSISTEO NORTH HOSPICE, LLC
Street 919 12TH PLACE STE 6
City PRESCOTT
State AZ
ZIP 86305
Phone 602 820-8094
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Hospice
Lab Director TERI ELLERBE

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