34D2137179 CLIA NUMBER - MEDI HOME HOSPICE

Laboratory Demographics

CLIA Number: 34D2137179

Facility Name: MEDI HOME HOSPICE

Facility Address:
564 W MCLEAN STREET, STE B
SAINT PAULS, NC
ZIP 28384
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Facility Phone Number: 910 671-6842

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1831634179

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	34D2137179
LAB Type	Hospice
Facility Name	MEDI HOME HOSPICE
Street	564 W MCLEAN STREET, STE B
City	SAINT PAULS
State	NC
ZIP	28384
Phone	910 671-6842
CertificateType	4
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	Waiver

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