05D2148182 CLIA NUMBER - SIMI PLAZA HOME CARE, INC.

Laboratory Demographics

CLIA Number: 05D2148182

Facility Name: SIMI PLAZA HOME CARE, INC.

Facility Address:
1716 ERRINGER RD STE 102
SIMI VALLEY, CA
ZIP 93065
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Facility Phone Number: 818 919-9191

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1619324241

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	05D2148182
LAB Type	Home Health Agency
Facility Name	SIMI PLAZA HOME CARE, INC.
Street	1716 ERRINGER RD STE 102
City	SIMI VALLEY
State	CA
ZIP	93065
Phone	818 919-9191
CertificateType	4
CertificateEffectiveDate	5/4/2024
CertificateExpirationDate	5/3/2026
FacilityType	Waiver

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