45D2117836 CLIA NUMBER - FOREST GATE HOSPICE DBA GOLDSTAR HOSPICE

Laboratory Demographics

  • CLIA Code: 45D2117836
  • Facility Name: FOREST GATE HOSPICE DBA GOLDSTAR HOSPICE
  • Facility Address: 5045 LORIMAR DR SUITE 240
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 403-0448
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: GRACY ZACHARIAH
  • NPI Number: 1891156030
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2117836
LAB Type Hospice
Facility Name FOREST GATE HOSPICE DBA GOLDSTAR HOSPICE
Street 5045 LORIMAR DR SUITE 240
City PLANO
State TX
ZIP 75093
Phone 972 403-0448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Hospice
Lab Director GRACY ZACHARIAH

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