39D2151692 CLIA NUMBER - VISTACARE USA, LLC D/B/A GENTIVA I

Laboratory Demographics

  • CLIA Code: 39D2151692
  • Facility Name: VISTACARE USA, LLC D/B/A GENTIVA I
  • Facility Address: 1777 SENTRY PARKWAY WEST, SUITE 110
    BLUE BELL, PA
    ZIP 19422
  • Facility Phone: 704 662-0416
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE BEASLEY
  • NPI Number: 1164478103
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 39D2151692
LAB Type Hospice
Facility Name VISTACARE USA, LLC D/B/A GENTIVA I
Street 1777 SENTRY PARKWAY WEST, SUITE 110
City BLUE BELL
State PA
ZIP 19422
Phone 704 662-0416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Hospice
Lab Director SELECE BEASLEY

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This page was last updated on: 9/29/2025