11D2080922 CLIA NUMBER - CARESOUTH HOSPICE, LLC DBA ENHABIT HOSPICE

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Laboratory Demographics

CLIA Number: 11D2080922

Facility Name: CARESOUTH HOSPICE, LLC DBA ENHABIT HOSPICE

Facility Address:
3920 ARKWRIGHT ROAD, SUITE 325A
MACON, GA
ZIP 31210
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Facility Phone Number: 478 474-1155

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1609210491

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	11D2080922
LAB Type	Hospice
Facility Name	CARESOUTH HOSPICE, LLC DBA ENHABIT HOSPICE
Street	3920 ARKWRIGHT ROAD, SUITE 325A
City	MACON
State	GA
ZIP	31210
Phone	478 474-1155
CertificateType	4
CertificateEffectiveDate	7/16/2022
CertificateExpirationDate	7/15/2024
FacilityType	Waiver

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