24D2298664 CLIA NUMBER - SUPERIOR HOSPICE INC

Laboratory Demographics

CLIA Number: 24D2298664

Facility Name: SUPERIOR HOSPICE INC

Facility Address:
800 BOONE AVE N STE 194
GOLDEN VALLEY, MN
ZIP 55427
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Facility Phone Number: 763 277-8777

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1265211171

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	24D2298664
LAB Type	Hospice
Facility Name	SUPERIOR HOSPICE INC
Street	800 BOONE AVE N STE 194
City	GOLDEN VALLEY
State	MN
ZIP	55427
Phone	763 277-8777
CertificateType	4
CertificateEffectiveDate	2/6/2024
CertificateExpirationDate	2/5/2026
FacilityType	Waiver

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