45D2131773 CLIA NUMBER - PREMIER HOSPICE LLC

Laboratory Demographics

CLIA Number: 45D2131773

Facility Name: PREMIER HOSPICE LLC

Facility Address:
2011 TUCUMCARI DR
HOUSTON, TX
ZIP 77090
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Facility Phone Number: 832 602-5930

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1124561055

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2131773
LAB Type	Hospice
Facility Name	PREMIER HOSPICE LLC
Street	2011 TUCUMCARI DR
City	HOUSTON
State	TX
ZIP	77090
Phone	832 602-5930
CertificateType	4
CertificateEffectiveDate	6/6/2023
CertificateExpirationDate	6/5/2025
FacilityType	Waiver

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