36D2028188 CLIA NUMBER - WESLEY HOSPICE

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Laboratory Demographics

CLIA Number: 36D2028188

Facility Name: WESLEY HOSPICE

Facility Address:
4588 WESLEY WOODS BLVD, SUITE 2A
NEW ALBANY, OH
ZIP 43054
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Facility Phone Number: 614 451-6700

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1821326125

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	36D2028188
LAB Type	Hospice
Facility Name	WESLEY HOSPICE
Street	4588 WESLEY WOODS BLVD, SUITE 2A
City	NEW ALBANY
State	OH
ZIP	43054
Phone	614 451-6700
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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