16D1089737 CLIA NUMBER - HOSPICE OF JACKSON COUNTY

Laboratory Demographics

CLIA Number: 16D1089737

Facility Name: HOSPICE OF JACKSON COUNTY

Facility Address:
611 WEST QUARRY STREET
MAQUOKETA, IA
ZIP 52060
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Facility Phone Number: 563 652-0123

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1609873769

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	16D1089737
LAB Type	Hospice
Facility Name	HOSPICE OF JACKSON COUNTY
Street	611 WEST QUARRY STREET
City	MAQUOKETA
State	IA
ZIP	52060
Phone	563 652-0123
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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