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05D2117766 CLIA NUMBER - GUARDIAN ANGEL HOME CARE OF SAN JOSE LLC

Laboratory Demographics

CLIA Number: 05D2117766

Facility Name: GUARDIAN ANGEL HOME CARE OF SAN JOSE LLC

Facility Address:
1885 THE ALAMEDA STE 208
SAN JOSE, CA
ZIP 95126
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Facility Phone Number: 248 293-2418

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1629116769

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 05D2117766
LAB Type Home Health Agency
Facility Name GUARDIAN ANGEL HOME CARE OF SAN JOSE LLC
Street 1885 THE ALAMEDA STE 208
City SAN JOSE
State CA
ZIP 95126
Phone 248 293-2418
CertificateType 4
CertificateEffectiveDate 8/23/2022
CertificateExpirationDate 8/22/2024
FacilityType Waiver

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