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05D2159354 CLIA NUMBER - LIGHT HOME CARE, INC

Laboratory Demographics

CLIA Number: 05D2159354

Facility Name: LIGHT HOME CARE, INC

Facility Address:
511 E HARVARD SUITE 1
GLENDALE, CA
ZIP 91205
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Facility Phone Number: 818 500-9012

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1386002970

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 05D2159354
LAB Type Home Health Agency
Facility Name LIGHT HOME CARE, INC
Street 511 E HARVARD SUITE 1
City GLENDALE
State CA
ZIP 91205
Phone 818 500-9012
CertificateType 4
CertificateEffectiveDate 12/18/2022
CertificateExpirationDate 12/17/2024
FacilityType Waiver

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