52D2212848 CLIA NUMBER - GREAT LAKES HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 52D2212848
  • Facility Name: GREAT LAKES HOSPICE LLC
  • Facility Address: 5150 N PORT WASHINGTON RD
    GLENDALE, WI
    ZIP 53217
  • Facility Phone: 816 200-2385
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CURTISS ELLIOTT
  • NPI Number: 1205433778
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 52D2212848
LAB Type Hospice
Facility Name GREAT LAKES HOSPICE LLC
Street 5150 N PORT WASHINGTON RD
City GLENDALE
State WI
ZIP 53217
Phone 816 200-2385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Hospice
Lab Director CURTISS ELLIOTT

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