36D2037191 CLIA NUMBER - PACIFIC HOME CARE, LLC

Laboratory Demographics

  • CLIA Code: 36D2037191
  • Facility Name: PACIFIC HOME CARE, LLC
  • Facility Address: 4713 WEST 130TH ST
    CLEVELAND, OH
    ZIP 44135
  • Facility Phone: 216 458-5756
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ABDULLAHI A. ALI
  • NPI Number: 1730468448
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 36D2037191
LAB Type Home Health Agency
Facility Name PACIFIC HOME CARE, LLC
Street 4713 WEST 130TH ST
City CLEVELAND
State OH
ZIP 44135
Phone 216 458-5756
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Home Health Agency
Lab Director ABDULLAHI A. ALI

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This page was last updated on: 9/29/2025