45D2191916 CLIA NUMBER - MOUNT OLIVE HOSPICE AND PALLIATIVE CARE LLC

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Laboratory Demographics

CLIA Number: 45D2191916

Facility Name: MOUNT OLIVE HOSPICE AND PALLIATIVE CARE LLC

Facility Address:
10998 S WILCREST DR STE 122
HOUSTON, TX
ZIP 77099
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Facility Phone Number: 713 517-4107

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1447860846

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2191916
LAB Type	Hospice
Facility Name	MOUNT OLIVE HOSPICE AND PALLIATIVE CARE LLC
Street	10998 S WILCREST DR STE 122
City	HOUSTON
State	TX
ZIP	77099
Phone	713 517-4107
CertificateType	4
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	Waiver

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