35D2096756 CLIA NUMBER - ETHOS HOME CARE AND HOSPICE

Laboratory Demographics

  • CLIA Code: 35D2096756
  • Facility Name: ETHOS HOME CARE AND HOSPICE
  • Facility Address: 3361 45TH ST S SUITE 100
    FARGO, ND
    ZIP 58104
  • Facility Phone: 701 757-0328
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SCOTT HOLM
  • NPI Number: 1043636723
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 35D2096756
LAB Type Home Health Agency
Facility Name ETHOS HOME CARE AND HOSPICE
Street 3361 45TH ST S SUITE 100
City FARGO
State ND
ZIP 58104
Phone 701 757-0328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Home Health Agency
Lab Director SCOTT HOLM

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This page was last updated on: 9/29/2025