03D2189690 CLIA NUMBER - STONERIDGE HOSPICE

Laboratory Demographics

CLIA Number: 03D2189690

Facility Name: STONERIDGE HOSPICE

Facility Address:
20860 N TATUM BLVD STE 145
PHOENIX, AZ
ZIP 85050
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Facility Phone Number: 480 306-8655

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1447885843

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2189690
LAB Type	Hospice
Facility Name	STONERIDGE HOSPICE
Street	20860 N TATUM BLVD STE 145
City	PHOENIX
State	AZ
ZIP	85050
Phone	480 306-8655
CertificateType	4
CertificateEffectiveDate	8/4/2022
CertificateExpirationDate	8/3/2024
FacilityType	Waiver

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