03D2327068 CLIA NUMBER - ALAGA HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 03D2327068
  • Facility Name: ALAGA HOSPICE LLC
  • Facility Address: 3250 GATEWAY BLVD STE 112
    PRESCOTT, AZ
    ZIP 86303
  • Facility Phone: 928 350-7900
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JOHN MICHAEL BLANCO MATA
  • NPI Number: 1801540109
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 03D2327068
LAB Type Hospice
Facility Name ALAGA HOSPICE LLC
Street 3250 GATEWAY BLVD STE 112
City PRESCOTT
State AZ
ZIP 86303
Phone 928 350-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Hospice
Lab Director JOHN MICHAEL BLANCO MATA

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