16D2020479 CLIA NUMBER - GENESIS HOSPICE

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Laboratory Demographics

CLIA Number: 16D2020479

Facility Name: GENESIS HOSPICE

Facility Address:
2546 TECH DRIVE
BETTENDORF, IA
ZIP 52722
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Facility Phone Number: 563 421-5425

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1013968262

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	16D2020479
LAB Type	Hospice
Facility Name	GENESIS HOSPICE
Street	2546 TECH DRIVE
City	BETTENDORF
State	IA
ZIP	52722
Phone	563 421-5425
CertificateType	4
CertificateEffectiveDate	2/21/2023
CertificateExpirationDate	2/20/2025
FacilityType	Waiver

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