11D2220804 CLIA NUMBER - HOSPICE CARE OF GEORGIA, LLC DBA GEORGIA HOSPICE CARE

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Laboratory Demographics

CLIA Number: 11D2220804

Facility Name: HOSPICE CARE OF GEORGIA, LLC DBA GEORGIA HOSPICE CARE

Facility Address:
2743 PERIMETER PARKWAY, SUITE 230
AUGUSTA, GA
ZIP 30909
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Facility Phone Number: 864 327-6479

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1821042367

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	11D2220804
LAB Type	Hospice
Facility Name	HOSPICE CARE OF GEORGIA, LLC DBA GEORGIA HOSPICE CARE
Street	2743 PERIMETER PARKWAY, SUITE 230
City	AUGUSTA
State	GA
ZIP	30909
Phone	864 327-6479
CertificateType	4
CertificateEffectiveDate	4/15/2023
CertificateExpirationDate	4/14/2025
FacilityType	Waiver

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