11D2062132 CLIA NUMBER - HOMESTEAD HOSPICE OF NORTHWEST GEORGIA, LLC DBA TRADITIONS HEALTH

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Laboratory Demographics

CLIA Number: 11D2062132

Facility Name: HOMESTEAD HOSPICE OF NORTHWEST GEORGIA, LLC DBA TRADITIONS HEALTH

Facility Address:
1209 STARR DRIVE
DALTON, GA
ZIP 30720
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Facility Phone Number: 706 217-1926

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1174960678

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	11D2062132
LAB Type	Hospice
Facility Name	HOMESTEAD HOSPICE OF NORTHWEST GEORGIA, LLC DBA TRADITIONS HEALTH
Street	1209 STARR DRIVE
City	DALTON
State	GA
ZIP	30720
Phone	706 217-1926
CertificateType	4
CertificateEffectiveDate	7/11/2023
CertificateExpirationDate	7/10/2025
FacilityType	Waiver

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