45D2158879 CLIA NUMBER - FAMILY HOSPICE LTD, DBA GENTIVA

Laboratory Demographics

  • CLIA Code: 45D2158879
  • Facility Name: FAMILY HOSPICE LTD, DBA GENTIVA
  • Facility Address: 4040 BROADWAY ST, STE 305 & 306
    SAN ANTONIO, TX
    ZIP 78209
  • Facility Phone: 704 664-2876
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE Y. BEASLEY
  • NPI Number: 1265441190
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2158879
LAB Type Hospice
Facility Name FAMILY HOSPICE LTD, DBA GENTIVA
Street 4040 BROADWAY ST, STE 305 & 306
City SAN ANTONIO
State TX
ZIP 78209
Phone 704 664-2876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Hospice
Lab Director SELECE Y. BEASLEY

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