45D2255779 CLIA NUMBER - LIGHT HOUSE HOSPICE CARE SERVICES LLC

Laboratory Demographics

CLIA Number: 45D2255779

Facility Name: LIGHT HOUSE HOSPICE CARE SERVICES LLC

Facility Address:
19903 SONTERRA LANE
RICHMOND, TX
ZIP 77407
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Facility Phone Number: 832 614-6358

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1033860374

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D2255779
LAB Type	Hospice
Facility Name	LIGHT HOUSE HOSPICE CARE SERVICES LLC
Street	19903 SONTERRA LANE
City	RICHMOND
State	TX
ZIP	77407
Phone	832 614-6358
CertificateType	4
CertificateEffectiveDate	3/17/2024
CertificateExpirationDate	3/16/2026
FacilityType	Waiver

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