22D2179327 CLIA NUMBER - NATIONWIDE HOME CARE SERVICES LLC

Laboratory Demographics

CLIA Number: 22D2179327

Facility Name: NATIONWIDE HOME CARE SERVICES LLC

Facility Address:
112 CENTRAL AVE
MEDFORD, MA
ZIP 02155
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Facility Phone Number: 781 219-9491

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1386122042

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	22D2179327
LAB Type	Home Health Agency
Facility Name	NATIONWIDE HOME CARE SERVICES LLC
Street	112 CENTRAL AVE
City	MEDFORD
State	MA
ZIP	02155
Phone	781 219-9491
CertificateType	4
CertificateEffectiveDate	2/20/2024
CertificateExpirationDate	2/19/2026
FacilityType	Waiver

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