38D2060884 CLIA NUMBER - HIGH DESERT HOSPICE, LLC

Laboratory Demographics

CLIA Number: 38D2060884

Facility Name: HIGH DESERT HOSPICE, LLC

Facility Address:
2210 SHALLOCK AVE
KLAMATH FALLS, OR
ZIP 97601
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Facility Phone Number: 541 882-1636

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1033191440

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name Field Value
CLIA Number 38D2060884
LAB Type Hospice
Facility Name HIGH DESERT HOSPICE, LLC
Street 2210 SHALLOCK AVE
City KLAMATH FALLS
State OR
ZIP 97601
Phone 541 882-1636
CertificateType 4
CertificateEffectiveDate 6/19/2023
CertificateExpirationDate 6/18/2025
FacilityType Waiver

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