36D2128289 CLIA NUMBER - AVALON HOSPICE OHIO, LLC

Laboratory Demographics

  • CLIA Code: 36D2128289
  • Facility Name: AVALON HOSPICE OHIO, LLC
  • Facility Address: 4010 EXECUTIVE PARK DRIVE SUITE 225
    CINCINNATI, OH
    ZIP 45241
  • Facility Phone: 704 662-0416
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: KELLY SANDERS
  • NPI Number: 1316484785
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 36D2128289
LAB Type Hospice
Facility Name AVALON HOSPICE OHIO, LLC
Street 4010 EXECUTIVE PARK DRIVE SUITE 225
City CINCINNATI
State OH
ZIP 45241
Phone 704 662-0416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Hospice
Lab Director KELLY SANDERS

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