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10D1091388 CLIA NUMBER - ADVANCE CARE HOME HEALTH AGENCY INC

Laboratory Demographics

CLIA Number: 10D1091388

Facility Name: ADVANCE CARE HOME HEALTH AGENCY INC

Facility Address:
114 DEL PRADO BLVD S, 2ND FL
CAPE CORAL, FL
ZIP 33990
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Facility Phone Number: 239 443-5300

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver
NPI Number: 1285881722

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 10D1091388
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ADVANCE CARE HOME HEALTH AGENCY INC
Street 114 DEL PRADO BLVD S, 2ND FL
City CAPE CORAL
State FL
ZIP 33990
Phone 239 443-5300
CertificateType 4
CertificateEffectiveDate 10/31/2022
CertificateExpirationDate 10/30/2024
FacilityType Waiver

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