29D1094774 CLIA NUMBER - FAITH HOME HEALTH CARE, LLC

Laboratory Demographics

CLIA Number: 29D1094774

Facility Name: FAITH HOME HEALTH CARE, LLC

Facility Address:
6845 W CHARLESTON BLVD STE B
LAS VEGAS, NV
ZIP 89117
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Facility Phone Number: 702 474-9007

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1235388257

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	29D1094774
LAB Type	Home Health Agency
Facility Name	FAITH HOME HEALTH CARE, LLC
Street	6845 W CHARLESTON BLVD STE B
City	LAS VEGAS
State	NV
ZIP	89117
Phone	702 474-9007
CertificateType	4
CertificateEffectiveDate	8/9/2023
CertificateExpirationDate	8/8/2025
FacilityType	Waiver

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