45D2161790 CLIA NUMBER - WKM HOSPICE, LLC DBA AVATAR HEALTHCARE

Laboratory Demographics

  • CLIA Code: 45D2161790
  • Facility Name: WKM HOSPICE, LLC DBA AVATAR HEALTHCARE
  • Facility Address: 3014 E US HWY 377
    GRANBURY, TX
    ZIP 76049
  • Facility Phone: 972 416-8500
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ANI GOPALAKRISHNAN
  • NPI Number: 1033669973
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2161790
LAB Type Hospice
Facility Name WKM HOSPICE, LLC DBA AVATAR HEALTHCARE
Street 3014 E US HWY 377
City GRANBURY
State TX
ZIP 76049
Phone 972 416-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Hospice
Lab Director ANI GOPALAKRISHNAN

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