24D2157009 CLIA NUMBER - VISTA HOSPICECARE, LLC DBA GENTIVA II

Laboratory Demographics

  • CLIA Code: 24D2157009
  • Facility Name: VISTA HOSPICECARE, LLC DBA GENTIVA II
  • Facility Address: 8000 W 78TH STREET, SUITE 210
    EDINA, MN
    ZIP 55439
  • Facility Phone: 704 664-2876
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE Y. BEASLEY
  • NPI Number: 1750736625
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 24D2157009
LAB Type Hospice
Facility Name VISTA HOSPICECARE, LLC DBA GENTIVA II
Street 8000 W 78TH STREET, SUITE 210
City EDINA
State MN
ZIP 55439
Phone 704 664-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Hospice
Lab Director SELECE Y. BEASLEY

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This page was last updated on: 9/29/2025