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05D2038816 CLIA NUMBER - GREEN MEADOWS HOME HEALTH INC

Laboratory Demographics

CLIA Number: 05D2038816

Facility Name: GREEN MEADOWS HOME HEALTH INC

Facility Address:
1442 IRVINE BLVD STE 104
TUSTIN, CA
ZIP 92780
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Facility Phone Number: 714 838-1055

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1457656332

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 05D2038816
LAB Type Home Health Agency
Facility Name GREEN MEADOWS HOME HEALTH INC
Street 1442 IRVINE BLVD STE 104
City TUSTIN
State CA
ZIP 92780
Phone 714 838-1055
CertificateType 4
CertificateEffectiveDate 4/25/2023
CertificateExpirationDate 4/24/2025
FacilityType Waiver

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