45D2157306 CLIA NUMBER - FAMILY HOSPICE, LTD DBA GENTIVA

Laboratory Demographics

CLIA Number: 45D2157306

Facility Name: FAMILY HOSPICE, LTD DBA GENTIVA

Facility Address:
7557 RAMBLER RD SUITE 560
DALLAS, TX
ZIP 75231
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Facility Phone Number: 704 664-2876

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1033129887

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2157306
LAB Type	Hospice
Facility Name	FAMILY HOSPICE, LTD DBA GENTIVA
Street	7557 RAMBLER RD SUITE 560
City	DALLAS
State	TX
ZIP	75231
Phone	704 664-2876
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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