45D2142928 CLIA NUMBER - SHALEM HOSPICE CARE, LLC

Laboratory Demographics

CLIA Number: 45D2142928

Facility Name: SHALEM HOSPICE CARE, LLC

Facility Address:
2611 BELTLINE ROAD SUITE 127A
SUNNYVALE, TX
ZIP 75182
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Facility Phone Number: 972 803-4620

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1659881761

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2142928
LAB Type	Hospice
Facility Name	SHALEM HOSPICE CARE, LLC
Street	2611 BELTLINE ROAD SUITE 127A
City	SUNNYVALE
State	TX
ZIP	75182
Phone	972 803-4620
CertificateType	4
CertificateEffectiveDate	1/23/2024
CertificateExpirationDate	1/22/2026
FacilityType	Waiver

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