05D0902755 CLIA NUMBER - VISTA HOME HEALTH SERVICES, INC

Laboratory Demographics

CLIA Number: 05D0902755

Facility Name: VISTA HOME HEALTH SERVICES, INC

Facility Address:
343 E PALMDALE BLVD, STE 4
PALMDALE, CA
ZIP 93550
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Facility Phone Number: 661 267-0097

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1841291002

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 05D0902755
LAB Type Home Health Agency
Facility Name VISTA HOME HEALTH SERVICES, INC
Street 343 E PALMDALE BLVD, STE 4
City PALMDALE
State CA
ZIP 93550
Phone 661 267-0097
CertificateType 4
CertificateEffectiveDate 6/28/2023
CertificateExpirationDate 6/27/2025
FacilityType Waiver

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