24D2258091 CLIA NUMBER - FAVOURED HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 24D2258091
  • Facility Name: FAVOURED HOSPICE, LLC
  • Facility Address: 11920 134TH AVE N
    DAYTON, MN
    ZIP 55327
  • Facility Phone: 763 377-3775
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: FRANKLIN ANGWENYI
  • NPI Number: 1902567647
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 24D2258091
LAB Type Hospice
Facility Name FAVOURED HOSPICE, LLC
Street 11920 134TH AVE N
City DAYTON
State MN
ZIP 55327
Phone 763 377-3775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Hospice
Lab Director FRANKLIN ANGWENYI

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