40D0901906 CLIA NUMBER - HOSPICIO LA MONTANA

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Laboratory Demographics

CLIA Number: 40D0901906

Facility Name: HOSPICIO LA MONTANA

Facility Address:
CARR 164 SECTOR EL DESVIO BO ACHIOTE
NARANJITO, PR
ZIP 00719
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Facility Phone Number: 787 857-5800

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1235635731

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	40D0901906
LAB Type	Home Health Agency
Facility Name	HOSPICIO LA MONTANA
Street	CARR 164 SECTOR EL DESVIO BO ACHIOTE
City	NARANJITO
State	PR
ZIP	00719
Phone	787 857-5800
CertificateType	4
CertificateEffectiveDate	6/8/2023
CertificateExpirationDate	6/7/2025
FacilityType	Waiver

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