45D2272591 CLIA NUMBER - RED MAPLE HOSPICE

Laboratory Demographics

  • CLIA Code: 45D2272591
  • Facility Name: RED MAPLE HOSPICE
  • Facility Address: 16300 CULLEN PARK WAY
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 469 902-4402
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CHARLES AYENI
  • NPI Number: 1538877709
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2272591
LAB Type Hospice
Facility Name RED MAPLE HOSPICE
Street 16300 CULLEN PARK WAY
City PROSPER
State TX
ZIP 75078
Phone 469 902-4402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Hospice
Lab Director CHARLES AYENI

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