14D2078566 CLIA NUMBER - BREEZE HOSPICE L L C

Laboratory Demographics

  • CLIA Code: 14D2078566
  • Facility Name: BREEZE HOSPICE L L C
  • Facility Address: 14 B PARK PLACE - STE B
    SWANSEA, IL
    ZIP 62226
  • Facility Phone: 618 416-6410
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SHEILA M. FASZOLD
  • NPI Number: 1669898805
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 14D2078566
LAB Type Hospice
Facility Name BREEZE HOSPICE L L C
Street 14 B PARK PLACE - STE B
City SWANSEA
State IL
ZIP 62226
Phone 618 416-6410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Hospice
Lab Director SHEILA M. FASZOLD

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This page was last updated on: 9/29/2025