11D2259289 CLIA NUMBER - RADIANT HOSPICE & PALLIATIVE CARE

Laboratory Demographics

CLIA Number: 11D2259289

Facility Name: RADIANT HOSPICE & PALLIATIVE CARE

Facility Address:
2340 PATRICK HENRY PKWY, SUITE 250
MCDONOUGH, GA
ZIP 30253
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Facility Phone Number: 678 729-8761

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1649863846

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	11D2259289
LAB Type	Hospice
Facility Name	RADIANT HOSPICE & PALLIATIVE CARE
Street	2340 PATRICK HENRY PKWY, SUITE 250
City	MCDONOUGH
State	GA
ZIP	30253
Phone	678 729-8761
CertificateType	4
CertificateEffectiveDate	5/4/2024
CertificateExpirationDate	5/3/2026
FacilityType	Waiver

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