45D2066649 CLIA NUMBER - BRIDGE OF LIFE HOSPICE

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Laboratory Demographics

CLIA Number: 45D2066649

Facility Name: BRIDGE OF LIFE HOSPICE

Facility Address:
7400 LOUIS PASTEUR, SUITE 105
SAN ANTONIO, TX
ZIP 78229
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Facility Phone Number: 210 912-9688

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1104284942

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2066649
LAB Type	Home Health Agency
Facility Name	BRIDGE OF LIFE HOSPICE
Street	7400 LOUIS PASTEUR, SUITE 105
City	SAN ANTONIO
State	TX
ZIP	78229
Phone	210 912-9688
CertificateType	4
CertificateEffectiveDate	10/1/2023
CertificateExpirationDate	9/30/2025
FacilityType	Waiver

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