24D2181235 CLIA NUMBER - PRESTIGE HOME HEALTH CARE, LLC

Laboratory Demographics

CLIA Number: 24D2181235

Facility Name: PRESTIGE HOME HEALTH CARE, LLC

Facility Address:
8140 XENIA AVE N
BROOKLYN PARK, MN
ZIP 55443
Get Directions

Facility Phone Number: 763 496-9359

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1154861748

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	24D2181235
LAB Type	Assisted Living Facility
Facility Name	PRESTIGE HOME HEALTH CARE, LLC
Street	8140 XENIA AVE N
City	BROOKLYN PARK
State	MN
ZIP	55443
Phone	763 496-9359
CertificateType	4
CertificateEffectiveDate	3/30/2024
CertificateExpirationDate	3/29/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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