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03D2177450 CLIA NUMBER - ANGELS CARE HOME HEALTH OF ARIZONA NO 5

Laboratory Demographics

CLIA Number: 03D2177450

Facility Name: ANGELS CARE HOME HEALTH OF ARIZONA NO 5

Facility Address:
1030 N SAN FRANCISCO ST STE 110
FLAGSTAFF, AZ
ZIP 86001
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Facility Phone Number: 928 773-7570

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1730728502

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 03D2177450
LAB Type Home Health Agency
Facility Name ANGELS CARE HOME HEALTH OF ARIZONA NO 5
Street 1030 N SAN FRANCISCO ST STE 110
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 773-7570
CertificateType 4
CertificateEffectiveDate 1/10/2024
CertificateExpirationDate 1/9/2026
FacilityType Waiver

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