11D2188248 CLIA NUMBER - CARITAS HOSPICE CARE

Laboratory Demographics

CLIA Number: 11D2188248

Facility Name: CARITAS HOSPICE CARE

Facility Address:
800 OLD DAWSON VILLAGE ROAD, SUITE 020
DAWSONVILLE, GA
ZIP 30534
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Facility Phone Number: 678 239-1851

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1912460080

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	11D2188248
LAB Type	Hospice
Facility Name	CARITAS HOSPICE CARE
Street	800 OLD DAWSON VILLAGE ROAD, SUITE 020
City	DAWSONVILLE
State	GA
ZIP	30534
Phone	678 239-1851
CertificateType	4
CertificateEffectiveDate	7/15/2022
CertificateExpirationDate	7/14/2024
FacilityType	Waiver

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