45D2062687 CLIA NUMBER - PEACEWAY HOSPICE LLC

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Laboratory Demographics

CLIA Number: 45D2062687

Facility Name: PEACEWAY HOSPICE LLC

Facility Address:
3200 BROADWAY BLVD, SUITE 220
GARLAND, TX
ZIP 75043
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Facility Phone Number: 972 278-0905

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1346683943

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2062687
LAB Type	Hospice
Facility Name	PEACEWAY HOSPICE LLC
Street	3200 BROADWAY BLVD, SUITE 220
City	GARLAND
State	TX
ZIP	75043
Phone	972 278-0905
CertificateType	4
CertificateEffectiveDate	7/19/2023
CertificateExpirationDate	7/18/2025
FacilityType	Waiver

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