39D1032340 CLIA NUMBER - BETHANY HOSPICE SVCS OF W PA LLC

Laboratory Demographics

CLIA Number: 39D1032340

Facility Name: BETHANY HOSPICE SVCS OF W PA LLC

Facility Address:
400 HOLIDAY DRIVE, SUITE 101
PITTSBURGH, PA
ZIP 15220
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Facility Phone Number: 412 921-2209

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1770583908

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	39D1032340
LAB Type	Physician Office
Facility Name	BETHANY HOSPICE SVCS OF W PA LLC
Street	400 HOLIDAY DRIVE, SUITE 101
City	PITTSBURGH
State	PA
ZIP	15220
Phone	412 921-2209
CertificateType	4
CertificateEffectiveDate	10/21/2022
CertificateExpirationDate	10/20/2024
FacilityType	Waiver

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