14D2197335 CLIA NUMBER - BLESSING HOSPICE

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Laboratory Demographics

CLIA Number: 14D2197335

Facility Name: BLESSING HOSPICE

Facility Address:
5011 OAK ST
QUINCY, IL
ZIP 62305
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Facility Phone Number: 217 228-5521

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1558997379

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2197335
LAB Type	Hospice
Facility Name	BLESSING HOSPICE
Street	5011 OAK ST
City	QUINCY
State	IL
ZIP	62305
Phone	217 228-5521
CertificateType	4
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Waiver

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