53D2225168 CLIA NUMBER - EH HOSPICE OF THE WEST LLC DBA/ENHABIT HOSPICE

Laboratory Demographics

CLIA Number: 53D2225168

Facility Name: EH HOSPICE OF THE WEST LLC DBA/ENHABIT HOSPICE

Facility Address:
4024 LARAMIE STREET
CHEYENNE, WY
ZIP 82001
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Facility Phone Number: 307 634-5970

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1720679319

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	53D2225168
LAB Type	Hospice
Facility Name	EH HOSPICE OF THE WEST LLC DBA/ENHABIT HOSPICE
Street	4024 LARAMIE STREET
City	CHEYENNE
State	WY
ZIP	82001
Phone	307 634-5970
CertificateType	4
CertificateEffectiveDate	5/19/2023
CertificateExpirationDate	5/18/2025
FacilityType	Waiver

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