25D2118347 CLIA NUMBER - HOMECARE HOSPICE NORTH, LLC

Laboratory Demographics

CLIA Number: 25D2118347

Facility Name: HOMECARE HOSPICE NORTH, LLC

Facility Address:
301 HWY 30 WEST
NEW ALBANY, MS
ZIP 38652
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Facility Phone Number: 662 539-7339

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1164893343

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	25D2118347
LAB Type	Hospice
Facility Name	HOMECARE HOSPICE NORTH, LLC
Street	301 HWY 30 WEST
City	NEW ALBANY
State	MS
ZIP	38652
Phone	662 539-7339
CertificateType	4
CertificateEffectiveDate	9/6/2022
CertificateExpirationDate	9/5/2024
FacilityType	Waiver

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