31D2121154 CLIA NUMBER - SWAN HOSPICE

Laboratory Demographics

CLIA Number: 31D2121154

Facility Name: SWAN HOSPICE

Facility Address:
15 AMERICA AVE SUITE 303
LAKEWOOD, NJ
ZIP 08701
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Facility Phone Number: 908 818-1700

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1205440757

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	31D2121154
LAB Type	Hospice
Facility Name	SWAN HOSPICE
Street	15 AMERICA AVE SUITE 303
City	LAKEWOOD
State	NJ
ZIP	08701
Phone	908 818-1700
CertificateType	4
CertificateEffectiveDate	11/1/2022
CertificateExpirationDate	10/31/2024
FacilityType	Waiver

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