45D1049328 CLIA NUMBER - BETHANY HOSPICE LLC DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 45D1049328
  • Facility Name: BETHANY HOSPICE LLC DBA GENTIVA
  • Facility Address: 2913 WILLIAMS DRIVE, SUITE 320
    GEORGETOWN, TX
    ZIP 78628
  • Facility Phone: 704 664-2876
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE Y. BEASLEY
  • NPI Number: 1295899284
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D1049328
LAB Type Hospice
Facility Name BETHANY HOSPICE LLC DBA GENTIVA
Street 2913 WILLIAMS DRIVE, SUITE 320
City GEORGETOWN
State TX
ZIP 78628
Phone 704 664-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Hospice
Lab Director SELECE Y. BEASLEY

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