15D2299461 CLIA NUMBER - SOLACE HOSPICE CARE

Laboratory Demographics

CLIA Number: 15D2299461

Facility Name: SOLACE HOSPICE CARE

Facility Address:
280 COMMERCIAL ST
ROANOKE, IN
ZIP 46783
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Facility Phone Number: 260 600-9912

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1366200511

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	15D2299461
LAB Type	Hospice
Facility Name	SOLACE HOSPICE CARE
Street	280 COMMERCIAL ST
City	ROANOKE
State	IN
ZIP	46783
Phone	260 600-9912
CertificateType	4
CertificateEffectiveDate	2/21/2024
CertificateExpirationDate	2/20/2026
FacilityType	Waiver

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