31D2232371 CLIA NUMBER - DEDICATED HOME CARE

Laboratory Demographics

CLIA Number: 31D2232371

Facility Name: DEDICATED HOME CARE

Facility Address:
614 SOUTH BLACKHORSE PIKE, SUITE 105
BLACKWOOD, NJ
ZIP 08012
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Facility Phone Number: 856 681-2371

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1881014140

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 31D2232371
LAB Type Home Health Agency
Facility Name DEDICATED HOME CARE
Street 614 SOUTH BLACKHORSE PIKE, SUITE 105
City BLACKWOOD
State NJ
ZIP 08012
Phone 856 681-2371
CertificateType 4
CertificateEffectiveDate 8/12/2023
CertificateExpirationDate 8/11/2025
FacilityType Waiver

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