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05D2131240 CLIA NUMBER - SYCAMORE GROVE HEALTHCARE LLC DBA ARDENT HOME HEALTH OF FRESNO

Laboratory Demographics

CLIA Number: 05D2131240

Facility Name: SYCAMORE GROVE HEALTHCARE LLC DBA ARDENT HOME HEALTH OF FRESNO

Facility Address:
2040 N WINERY AVE STE 101
FRESNO, CA
ZIP 93703
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Facility Phone Number: 559 408-5945

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1356705941

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 05D2131240
LAB Type Home Health Agency
Facility Name SYCAMORE GROVE HEALTHCARE LLC DBA ARDENT HOME HEALTH OF FRESNO
Street 2040 N WINERY AVE STE 101
City FRESNO
State CA
ZIP 93703
Phone 559 408-5945
CertificateType 4
CertificateEffectiveDate 5/24/2023
CertificateExpirationDate 5/23/2025
FacilityType Waiver

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