22D2246112 CLIA NUMBER - VISTACARE OF BOSTON, LLC

Laboratory Demographics

CLIA Number: 22D2246112

Facility Name: VISTACARE OF BOSTON, LLC

Facility Address:
2 TUPPER ROAD, UNIT 3
SANDWICH, MA
ZIP 02563
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Facility Phone Number: 704 664-2876

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1639450513

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	22D2246112
LAB Type	Hospice
Facility Name	VISTACARE OF BOSTON, LLC
Street	2 TUPPER ROAD, UNIT 3
City	SANDWICH
State	MA
ZIP	02563
Phone	704 664-2876
CertificateType	4
CertificateEffectiveDate	12/21/2023
CertificateExpirationDate	12/20/2025
FacilityType	Waiver

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