03D0986067 CLIA NUMBER - PROFESSIONAL HOME CARE SERVICES

Laboratory Demographics

CLIA Number: 03D0986067

Facility Name: PROFESSIONAL HOME CARE SERVICES

Facility Address:
7600 N 16TH STREET, SUITE 140
PHOENIX, AZ
ZIP 85020
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Facility Phone Number: 602 395-5100

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1598814758

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 03D0986067
LAB Type Home Health Agency
Facility Name PROFESSIONAL HOME CARE SERVICES
Street 7600 N 16TH STREET, SUITE 140
City PHOENIX
State AZ
ZIP 85020
Phone 602 395-5100
CertificateType 4
CertificateEffectiveDate 5/7/2023
CertificateExpirationDate 5/6/2025
FacilityType Waiver

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