45D2041338 CLIA NUMBER - ANGEL HOSPICE CORP

Laboratory Demographics

  • CLIA Code: 45D2041338
  • Facility Name: ANGEL HOSPICE CORP
  • Facility Address: 208 W KEARNEY SUITE 103
    MESQUITE, TX
    ZIP 75149
  • Facility Phone: 214 432-2636
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: PHEBA DANIEL
  • NPI Number: 1174897839
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2041338
LAB Type Hospice
Facility Name ANGEL HOSPICE CORP
Street 208 W KEARNEY SUITE 103
City MESQUITE
State TX
ZIP 75149
Phone 214 432-2636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Hospice
Lab Director PHEBA DANIEL

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