10D1106659 CLIA NUMBER - BLUE SKY HOME HEALTHCARE INC

Laboratory Demographics

CLIA Number: 10D1106659

Facility Name: BLUE SKY HOME HEALTHCARE INC

Facility Address:
1601 N PALM AVE STE 204 B
PEMBROKE PINES, FL
ZIP 33026
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Facility Phone Number: 954 639-7708

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1811131584

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	10D1106659
LAB Type	Home Health Agency
Facility Name	BLUE SKY HOME HEALTHCARE INC
Street	1601 N PALM AVE STE 204 B
City	PEMBROKE PINES
State	FL
ZIP	33026
Phone	954 639-7708
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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