38D2060884 CLIA NUMBER - HIGH DESERT HOSPICE, LLC

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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