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05D1092710 CLIA NUMBER - CAMARILLO SKILLED HOME HEALTH LLC

Laboratory Demographics

CLIA Number: 05D1092710

Facility Name: CAMARILLO SKILLED HOME HEALTH LLC

Facility Address:
450 ROSEWOOD AVE STE 213
CAMARILLO, CA
ZIP 93010
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Facility Phone Number: 805 987-2888

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1689825473

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 05D1092710
LAB Type Home Health Agency
Facility Name CAMARILLO SKILLED HOME HEALTH LLC
Street 450 ROSEWOOD AVE STE 213
City CAMARILLO
State CA
ZIP 93010
Phone 805 987-2888
CertificateType 4
CertificateEffectiveDate 12/2/2022
CertificateExpirationDate 12/1/2024
FacilityType Waiver

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