37D2286503 CLIA NUMBER - LEGACY FAMILY HOSPICE, LLC

Laboratory Demographics

CLIA Number: 37D2286503

Facility Name: LEGACY FAMILY HOSPICE, LLC

Facility Address:
3030 NW EXPRESSWAY, STE 875
OKLAHOMA CITY, OK
ZIP 73112
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Facility Phone Number: 405 832-0150

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1689313728

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	37D2286503
LAB Type	Hospice
Facility Name	LEGACY FAMILY HOSPICE, LLC
Street	3030 NW EXPRESSWAY, STE 875
City	OKLAHOMA CITY
State	OK
ZIP	73112
Phone	405 832-0150
CertificateType	4
CertificateEffectiveDate	7/31/2023
CertificateExpirationDate	7/30/2025
FacilityType	Waiver

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