37D2141826 CLIA NUMBER - ALLIED HOSPICE,LLC

Laboratory Demographics

CLIA Number: 37D2141826

Facility Name: ALLIED HOSPICE,LLC

Facility Address:
500 N POPLAR AVE
BROKEN ARROW, OK
ZIP 74012
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Facility Phone Number: 918 742-4269

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1104342815

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	37D2141826
LAB Type	Hospice
Facility Name	ALLIED HOSPICE,LLC
Street	500 N POPLAR AVE
City	BROKEN ARROW
State	OK
ZIP	74012
Phone	918 742-4269
CertificateType	4
CertificateEffectiveDate	12/21/2023
CertificateExpirationDate	12/20/2025
FacilityType	Waiver

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