05D2123994 CLIA NUMBER - GUARDIAN ANGEL HOME CARE OF SACRAMENTO LLC

Laboratory Demographics

CLIA Number: 05D2123994

Facility Name: GUARDIAN ANGEL HOME CARE OF SACRAMENTO LLC

Facility Address:
1451 RIVER PARK DR, STE 225
SACRAMENTO, CA
ZIP 95815
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Facility Phone Number: 248 293-2400

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1366087595

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	05D2123994
LAB Type	Home Health Agency
Facility Name	GUARDIAN ANGEL HOME CARE OF SACRAMENTO LLC
Street	1451 RIVER PARK DR, STE 225
City	SACRAMENTO
State	CA
ZIP	95815
Phone	248 293-2400
CertificateType	4
CertificateEffectiveDate	1/6/2023
CertificateExpirationDate	1/5/2025
FacilityType	Waiver

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