44D2172366 CLIA NUMBER - LHCG XCVI, LLC DBA BAPTIST MEMORIAL HOME CARE & HOSPICE

Laboratory Demographics

CLIA Number: 44D2172366

Facility Name: LHCG XCVI, LLC DBA BAPTIST MEMORIAL HOME CARE & HOSPICE

Facility Address:
641 RB WILSON DRIVE SUITE E
HUNTINGDON, TN
ZIP 38344
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Facility Phone Number: 731 986-3220

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1659807873

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	44D2172366
LAB Type	Hospice
Facility Name	LHCG XCVI, LLC DBA BAPTIST MEMORIAL HOME CARE & HOSPICE
Street	641 RB WILSON DRIVE SUITE E
City	HUNTINGDON
State	TN
ZIP	38344
Phone	731 986-3220
CertificateType	4
CertificateEffectiveDate	9/23/2023
CertificateExpirationDate	9/22/2025
FacilityType	Waiver

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