03D1065239 CLIA NUMBER - ELSA'S ADULT CARE HOME, LLC

Laboratory Demographics

CLIA Number: 03D1065239

Facility Name: ELSA'S ADULT CARE HOME, LLC

Facility Address:
6301 E CALLE DE SAN ALBERTO
TUCSON, AZ
ZIP 85710
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Facility Phone Number: 520 886-8283

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1578014437

Taxonomy: 311ZA0620X - Custodial Care Facility
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

CLIA Record

Field Name	Field Value
CLIA Number	03D1065239
LAB Type	Assisted Living Facility
Facility Name	ELSA'S ADULT CARE HOME, LLC
Street	6301 E CALLE DE SAN ALBERTO
City	TUCSON
State	AZ
ZIP	85710
Phone	520 886-8283
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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