05D2268627 CLIA NUMBER - BLOSSOM CARE INC

Laboratory Demographics

  • CLIA Code: 05D2268627
  • Facility Name: BLOSSOM CARE INC
  • Facility Address: 1500 W SHAW AVE STE 302
    FRESNO, CA
    ZIP 93711
  • Facility Phone: 559 430-5895
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANTONIS ANTONIOU
  • NPI Number: 1679196034
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2268627
LAB Type Home Health Agency
Facility Name BLOSSOM CARE INC
Street 1500 W SHAW AVE STE 302
City FRESNO
State CA
ZIP 93711
Phone 559 430-5895
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Home Health Agency
Lab Director ANTONIS ANTONIOU

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This page was last updated on: 9/29/2025