10D1003373 CLIA NUMBER - OMNI HOME HEALTH-JACKSONVILLE DBA APEX HOME HEALTHCARE

Laboratory Demographics

CLIA Number: 10D1003373

Facility Name: OMNI HOME HEALTH-JACKSONVILLE DBA APEX HOME HEALTHCARE

Facility Address:
2765 REBECCA LN SUITE A
ORANGE CITY, FL
ZIP 32763
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Facility Phone Number: 337 233-1307

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1467446203

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	10D1003373
LAB Type	Home Health Agency
Facility Name	OMNI HOME HEALTH-JACKSONVILLE DBA APEX HOME HEALTHCARE
Street	2765 REBECCA LN SUITE A
City	ORANGE CITY
State	FL
ZIP	32763
Phone	337 233-1307
CertificateType	4
CertificateEffectiveDate	8/28/2022
CertificateExpirationDate	8/27/2024
FacilityType	Waiver

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