45D2084168 CLIA NUMBER - BLUE HAVEN HOSPICE, LLC RELIANT AT HOME HOSPICE

Laboratory Demographics

  • CLIA Code: 45D2084168
  • Facility Name: BLUE HAVEN HOSPICE, LLC RELIANT AT HOME HOSPICE
  • Facility Address: 3033 W GEORGE BUSH HIGHWAY
    PLANO, TX
    ZIP 75075
  • Facility Phone: 214 667-8040
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CASEY A. WILSON
  • NPI Number: 1609287895
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2084168
LAB Type Hospice
Facility Name BLUE HAVEN HOSPICE, LLC RELIANT AT HOME HOSPICE
Street 3033 W GEORGE BUSH HIGHWAY
City PLANO
State TX
ZIP 75075
Phone 214 667-8040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Hospice
Lab Director CASEY A. WILSON

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