05D1075942 CLIA NUMBER - SERENITY HOSPICE LLC

Laboratory Demographics

CLIA Number: 05D1075942

Facility Name: SERENITY HOSPICE LLC

Facility Address:
777 E TAHQUITZ CANYON WAY STE 301
PALM SPRINGS, CA
ZIP 92262
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Facility Phone Number: 760 325-8718

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1003098856

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D1075942
LAB Type	Hospice
Facility Name	SERENITY HOSPICE LLC
Street	777 E TAHQUITZ CANYON WAY STE 301
City	PALM SPRINGS
State	CA
ZIP	92262
Phone	760 325-8718
CertificateType	4
CertificateEffectiveDate	11/1/2023
CertificateExpirationDate	10/31/2025
FacilityType	Waiver

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