52D1050902 CLIA NUMBER - HOSPICE PREFERRED CHOICE INC DBA AMEDISYS HOSPICE OF WAUKESHA

Laboratory Demographics

CLIA Number: 52D1050902

Facility Name: HOSPICE PREFERRED CHOICE INC DBA AMEDISYS HOSPICE OF WAUKESHA

Facility Address:
2204 E MORELAND BLVD, STE 101
WAUKESHA, WI
ZIP 53186
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Facility Phone Number: 262 785-1356

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1760421739

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	52D1050902
LAB Type	Hospice
Facility Name	HOSPICE PREFERRED CHOICE INC DBA AMEDISYS HOSPICE OF WAUKESHA
Street	2204 E MORELAND BLVD, STE 101
City	WAUKESHA
State	WI
ZIP	53186
Phone	262 785-1356
CertificateType	4
CertificateEffectiveDate	2/15/2024
CertificateExpirationDate	2/14/2026
FacilityType	Waiver

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