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10D0985591 CLIA NUMBER - MAXIM HEALTHCARE SERVICES INC

Laboratory Demographics

CLIA Number: 10D0985591

Facility Name: MAXIM HEALTHCARE SERVICES INC

Facility Address:
3510 S NOVA RD STE 111
PORT ORANGE, FL
ZIP 32129
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Facility Phone Number: 386 226-3494

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1659487262

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 10D0985591
LAB Type Home Health Agency
Facility Name MAXIM HEALTHCARE SERVICES INC
Street 3510 S NOVA RD STE 111
City PORT ORANGE
State FL
ZIP 32129
Phone 386 226-3494
CertificateType 4
CertificateEffectiveDate 4/24/2023
CertificateExpirationDate 4/23/2025
FacilityType Waiver

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