03D2192148 CLIA NUMBER - E HOSPICE GROUP OF ARIZONA NO 1, LLC DBA ANGELS CARE HOSPICE

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Laboratory Demographics

CLIA Number: 03D2192148

Facility Name: E HOSPICE GROUP OF ARIZONA NO 1, LLC DBA ANGELS CARE HOSPICE

Facility Address:
1000 WILLOW CREEK RD STE C
PRESCOTT, AZ
ZIP 86301
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Facility Phone Number: 928 379-2887

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1861020885

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2192148
LAB Type	Hospice
Facility Name	E HOSPICE GROUP OF ARIZONA NO 1, LLC DBA ANGELS CARE HOSPICE
Street	1000 WILLOW CREEK RD STE C
City	PRESCOTT
State	AZ
ZIP	86301
Phone	928 379-2887
CertificateType	4
CertificateEffectiveDate	9/4/2022
CertificateExpirationDate	9/3/2024
FacilityType	Waiver

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