03D2234112 CLIA NUMBER - ETERNITY HOME HEALTH CARE, LLC

Laboratory Demographics

CLIA Number: 03D2234112

Facility Name: ETERNITY HOME HEALTH CARE, LLC

Facility Address:
4140 N 108TH AVE STE 101C
PHOENIX, AZ
ZIP 85037
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Facility Phone Number: (623) 738-7644

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1699377549

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	03D2234112
LAB Type	HOME HEALTH AGENCY
Facility Name	ETERNITY HOME HEALTH CARE, LLC
Street	4140 N 108TH AVE STE 101C
City	PHOENIX
State	AZ
ZIP	85037
Phone	(623) 738-7644

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