45D1094122 CLIA NUMBER - AG HOSPICE, LLC, DBA THREE OAKS HOSPICE

Laboratory Demographics

  • CLIA Code: 45D1094122
  • Facility Name: AG HOSPICE, LLC, DBA THREE OAKS HOSPICE
  • Facility Address: 16420 PARK TEN PLACE, SUITE 240
    HOUSTON, TX
    ZIP 77084
  • Facility Phone: 832 437-2089
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CARLEA A. BROCK
  • NPI Number: 1891947040
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D1094122
LAB Type Hospice
Facility Name AG HOSPICE, LLC, DBA THREE OAKS HOSPICE
Street 16420 PARK TEN PLACE, SUITE 240
City HOUSTON
State TX
ZIP 77084
Phone 832 437-2089
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Hospice
Lab Director CARLEA A. BROCK

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