05D1083830 CLIA NUMBER - ALPHA HOME HEALTH

Laboratory Demographics

CLIA Number: 05D1083830

Facility Name: ALPHA HOME HEALTH

Facility Address:
3333 CONCOURS ST BLDG 7 STE 7100
ONTARIO, CA
ZIP 91764
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Facility Phone Number: 909 466-8200

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1366777567

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	05D1083830
LAB Type	Home Health Agency
Facility Name	ALPHA HOME HEALTH
Street	3333 CONCOURS ST BLDG 7 STE 7100
City	ONTARIO
State	CA
ZIP	91764
Phone	909 466-8200
CertificateType	4
CertificateEffectiveDate	6/9/2023
CertificateExpirationDate	6/8/2025
FacilityType	Waiver

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