13D2131361 CLIA NUMBER - LIGHTHOUSE HOSPICE

Laboratory Demographics

CLIA Number: 13D2131361

Facility Name: LIGHTHOUSE HOSPICE

Facility Address:
2667 E GALA CT STE 110
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: (208) 576-6383

Facility Type: HOSPICE

Certificate Type: Waiver

NPI Number: 1477096220

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	13D2131361
LAB Type	HOSPICE
Facility Name	LIGHTHOUSE HOSPICE
Street	2667 E GALA CT STE 110
City	MERIDIAN
State	ID
ZIP	83642
Phone	(208) 576-6383

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This page was last updated on: 5/11/2023