15D2173837 CLIA NUMBER - HEART TO HEART HOSPICE OF NORTHWEST INDIANA, LLC

Laboratory Demographics

CLIA Number: 15D2173837

Facility Name: HEART TO HEART HOSPICE OF NORTHWEST INDIANA, LLC

Facility Address:
402 WALL STREET, SUITE 12
VALPARAISO, IN
ZIP 46383
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Facility Phone Number: 219 252-4860

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1023667755

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	15D2173837
LAB Type	Hospice
Facility Name	HEART TO HEART HOSPICE OF NORTHWEST INDIANA, LLC
Street	402 WALL STREET, SUITE 12
City	VALPARAISO
State	IN
ZIP	46383
Phone	219 252-4860
CertificateType	4
CertificateEffectiveDate	10/21/2023
CertificateExpirationDate	10/20/2025
FacilityType	Waiver

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