23D2241029 CLIA NUMBER - LILY HOSPICE

Laboratory Demographics

CLIA Number: 23D2241029

Facility Name: LILY HOSPICE

Facility Address:
26645 W 12 MILE ROAD SUITE 211
SOUTHFIELD, MI
ZIP 48034
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Facility Phone Number: 248 955-5100

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1881234862

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	23D2241029
LAB Type	Hospice
Facility Name	LILY HOSPICE
Street	26645 W 12 MILE ROAD SUITE 211
City	SOUTHFIELD
State	MI
ZIP	48034
Phone	248 955-5100
CertificateType	4
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Waiver

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