34D0711562 CLIA NUMBER - GENTIVA CERTIFIED HEALTHCARE CORP

Laboratory Demographics

CLIA Number: 34D0711562

Facility Name: GENTIVA CERTIFIED HEALTHCARE CORP

Facility Address:
2000 FRONTIS PLAZA BLVD SUITE 300
WINSTON SALEM, NC
ZIP 27103
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Facility Phone Number: (336) 397-3820

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1578626321

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	34D0711562
LAB Type	HOME HEALTH AGENCY
Facility Name	GENTIVA CERTIFIED HEALTHCARE CORP
Street	2000 FRONTIS PLAZA BLVD SUITE 300
City	WINSTON SALEM
State	NC
ZIP	27103
Phone	(336) 397-3820

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This page was last updated on: 5/11/2023