34D2114247 CLIA NUMBER - WIREGRASS HOSPICE OF SOUTH CAROLINA DBA KINDRED HOSPICE

Laboratory Demographics

CLIA Number: 34D2114247

Facility Name: WIREGRASS HOSPICE OF SOUTH CAROLINA DBA KINDRED HOSPICE

Facility Address:
136 ROXBORO ROAD
OXFORD, NC
ZIP 27565
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Facility Phone Number: 704 664-2876

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1336584622

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	34D2114247
LAB Type	Hospice
Facility Name	WIREGRASS HOSPICE OF SOUTH CAROLINA DBA KINDRED HOSPICE
Street	136 ROXBORO ROAD
City	OXFORD
State	NC
ZIP	27565
Phone	704 664-2876
CertificateType	4
CertificateEffectiveDate	6/9/2022
CertificateExpirationDate	6/8/2024
FacilityType	Waiver

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