10D0871565 CLIA NUMBER - HOUSECALL HOME HEALTH LLC D/B/A AMEDISYS HOME HEALTH

Laboratory Demographics

CLIA Number: 10D0871565

Facility Name: HOUSECALL HOME HEALTH LLC D/B/A AMEDISYS HOME HEALTH

Facility Address:
1515 HERBERT ST STE 210
PORT ORANGE, FL
ZIP 32129
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Facility Phone Number: 386 788-8313

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1184672958

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	10D0871565
LAB Type	Home Health Agency
Facility Name	HOUSECALL HOME HEALTH LLC D/B/A AMEDISYS HOME HEALTH
Street	1515 HERBERT ST STE 210
City	PORT ORANGE
State	FL
ZIP	32129
Phone	386 788-8313
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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