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10D2069328 CLIA NUMBER - ABUNDANT LIFE HOME HEALTH AGENCY LLC

Laboratory Demographics

CLIA Number: 10D2069328

Facility Name: ABUNDANT LIFE HOME HEALTH AGENCY LLC

Facility Address:
28050 US HWY 19 N STE 205
CLEARWATER, FL
ZIP 33761
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Facility Phone Number: 727 286-8916

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1609523604

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 10D2069328
LAB Type Home Health Agency
Facility Name ABUNDANT LIFE HOME HEALTH AGENCY LLC
Street 28050 US HWY 19 N STE 205
City CLEARWATER
State FL
ZIP 33761
Phone 727 286-8916
CertificateType 4
CertificateEffectiveDate 11/21/2023
CertificateExpirationDate 11/20/2025
FacilityType Waiver

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