36D2031501 CLIA NUMBER - QUEEN CITY HOSPICE, LLC DBA QUEEN CITY HOSPICE

Laboratory Demographics

  • CLIA Code: 36D2031501
  • Facility Name: QUEEN CITY HOSPICE, LLC DBA QUEEN CITY HOSPICE
  • Facility Address: 4605 DUKE DRIVE, SUITE 220
    MASON, OH
    ZIP 45040
  • Facility Phone: 513 510-4406
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JENNIFER COTTERELL
  • NPI Number: 1437432929
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 36D2031501
LAB Type Hospice
Facility Name QUEEN CITY HOSPICE, LLC DBA QUEEN CITY HOSPICE
Street 4605 DUKE DRIVE, SUITE 220
City MASON
State OH
ZIP 45040
Phone 513 510-4406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2025
Certificate Expiration Date 10/19/2027
Facility Type Hospice
Lab Director JENNIFER COTTERELL

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