45D2285026 CLIA NUMBER - PELICAN HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 45D2285026
  • Facility Name: PELICAN HOSPICE LLC
  • Facility Address: 2735 VILLA CREEK DR STE 130L
    DALLAS, TX
    ZIP 75234
  • Facility Phone: 972 302-9756
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JOSEPH AJOMON
  • NPI Number: 1649961582
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2285026
LAB Type Hospice
Facility Name PELICAN HOSPICE LLC
Street 2735 VILLA CREEK DR STE 130L
City DALLAS
State TX
ZIP 75234
Phone 972 302-9756
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Hospice
Lab Director JOSEPH AJOMON

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