29D2175733 CLIA NUMBER - GRACE HOSPICE OF NEVADA LLC

Laboratory Demographics

CLIA Number: 29D2175733

Facility Name: GRACE HOSPICE OF NEVADA LLC

Facility Address:
5600 SPRING MOUNTAIN RD STE 204
LAS VEGAS, NV
ZIP 89146
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Facility Phone Number: 702 299-6068

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1962996793

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	29D2175733
LAB Type	Hospice
Facility Name	GRACE HOSPICE OF NEVADA LLC
Street	5600 SPRING MOUNTAIN RD STE 204
City	LAS VEGAS
State	NV
ZIP	89146
Phone	702 299-6068
CertificateType	4
CertificateEffectiveDate	11/27/2023
CertificateExpirationDate	11/26/2025
FacilityType	Waiver

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