03D2114999 CLIA NUMBER - GRAND CANYON HOME HEALTH CARE, INC

Laboratory Demographics

CLIA Number: 03D2114999

Facility Name: GRAND CANYON HOME HEALTH CARE, INC

Facility Address:
2320 W PEORIA AVE STE C122B
PHOENIX, AZ
ZIP 85029
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Facility Phone Number: (602) 441-2722

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1295213544

Taxonomy: 3747A0650X - Technician
An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.

CLIA Record

Field Name	Field Value
CLIA Number	03D2114999
LAB Type	HOME HEALTH AGENCY
Facility Name	GRAND CANYON HOME HEALTH CARE, INC
Street	2320 W PEORIA AVE STE C122B
City	PHOENIX
State	AZ
ZIP	85029
Phone	(602) 441-2722

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This page was last updated on: 5/11/2023