15D2233291 CLIA NUMBER - HAVEN HOSPICE IN, LLC DBA HAVEN HOSPICE

Laboratory Demographics

CLIA Number: 15D2233291

Facility Name: HAVEN HOSPICE IN, LLC DBA HAVEN HOSPICE

Facility Address:
1114 S HALLECK ST
DEMOTTE, IN
ZIP 46310
Get Directions

Facility Phone Number: 888 891-0786

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1386241057

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	15D2233291
LAB Type	Hospice
Facility Name	HAVEN HOSPICE IN, LLC DBA HAVEN HOSPICE
Street	1114 S HALLECK ST
City	DEMOTTE
State	IN
ZIP	46310
Phone	888 891-0786
CertificateType	4
CertificateEffectiveDate	8/23/2023
CertificateExpirationDate	8/22/2025
FacilityType	Waiver

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