Healther Providers Data Logo

05D0972724 CLIA NUMBER - KAISER FOUNDATION HOSPITALS ORANGE COUNTY HOME HEALTH

Laboratory Demographics

CLIA Number: 05D0972724

Facility Name: KAISER FOUNDATION HOSPITALS ORANGE COUNTY HOME HEALTH

Facility Address:
17542 E 17TH ST SUITE 300
TUSTIN, CA
ZIP 92780
Get Directions

Facility Phone Number: 714 734-4500

Facility Type: Health Main. Organization

Certificate Type: Waiver
NPI Number: 1588719579

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 05D0972724
LAB Type Health Main. Organization
Facility Name KAISER FOUNDATION HOSPITALS ORANGE COUNTY HOME HEALTH
Street 17542 E 17TH ST SUITE 300
City TUSTIN
State CA
ZIP 92780
Phone 714 734-4500
CertificateType 4
CertificateEffectiveDate 10/19/2023
CertificateExpirationDate 10/18/2025
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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