05D2142826 CLIA NUMBER - IMHOTEP, INC. DBA PRESIDENTIAL CARE HOME HEALTH

Laboratory Demographics

CLIA Number: 05D2142826

Facility Name: IMHOTEP, INC. DBA PRESIDENTIAL CARE HOME HEALTH

Facility Address:
337 N VINEYARD AVE STE 341
ONTARIO, CA
ZIP 91764
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Facility Phone Number: (909) 945-7087

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1134528342

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 05D2142826
LAB Type HOME HEALTH AGENCY
Facility Name IMHOTEP, INC. DBA PRESIDENTIAL CARE HOME HEALTH
Street 337 N VINEYARD AVE STE 341
City ONTARIO
State CA
ZIP 91764
Phone (909) 945-7087

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