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21D1073523 CLIA NUMBER - PROFESSIONAL HEALTHCARE RESOURCES OF MD

Laboratory Demographics

CLIA Number: 21D1073523

Facility Name: PROFESSIONAL HEALTHCARE RESOURCES OF MD

Facility Address:
10605 CONCORD STREET SUITE 309
KENSINGTON, MD
ZIP 20895
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Facility Phone Number: 240 395-0000

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1215084900

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 21D1073523
LAB Type Home Health Agency
Facility Name PROFESSIONAL HEALTHCARE RESOURCES OF MD
Street 10605 CONCORD STREET SUITE 309
City KENSINGTON
State MD
ZIP 20895
Phone 240 395-0000
CertificateType 4
CertificateEffectiveDate 9/11/2023
CertificateExpirationDate 9/10/2025
FacilityType Waiver

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