05D2057124 CLIA NUMBER - PRIME MED HOME HEALTH AGENCY INC

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Laboratory Demographics

CLIA Number: 05D2057124

Facility Name: PRIME MED HOME HEALTH AGENCY INC

Facility Address:
32260 ALVARADO BLVD
UNION CITY, CA
ZIP 94587
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Facility Phone Number: (510) 441-2406

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1659619971

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	05D2057124
LAB Type	HOME HEALTH AGENCY
Facility Name	PRIME MED HOME HEALTH AGENCY INC
Street	32260 ALVARADO BLVD
City	UNION CITY
State	CA
ZIP	94587
Phone	(510) 441-2406

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This page was last updated on: 5/11/2023