15D2173421 CLIA NUMBER - HEART TO HEART HOSPICE OF EVANSVILLE, LLC

Laboratory Demographics

CLIA Number: 15D2173421

Facility Name: HEART TO HEART HOSPICE OF EVANSVILLE, LLC

Facility Address:
610 E WALNUT STREET, SUITE A
EVANSVILLE, IN
ZIP 47713
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Facility Phone Number: 812 549-0373

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1588213425

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	15D2173421
LAB Type	Hospice
Facility Name	HEART TO HEART HOSPICE OF EVANSVILLE, LLC
Street	610 E WALNUT STREET, SUITE A
City	EVANSVILLE
State	IN
ZIP	47713
Phone	812 549-0373
CertificateType	4
CertificateEffectiveDate	10/11/2023
CertificateExpirationDate	10/10/2025
FacilityType	Waiver

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