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36D2252160 CLIA NUMBER - TRULY PEDIATRIC HOME CARE, LLC

Laboratory Demographics

CLIA Number: 36D2252160

Facility Name: TRULY PEDIATRIC HOME CARE, LLC

Facility Address:
3639 GREENBAY DR
DAYTON, OH
ZIP 45415
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Facility Phone Number: 937 397-3600

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1396358941

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 36D2252160
LAB Type Home Health Agency
Facility Name TRULY PEDIATRIC HOME CARE, LLC
Street 3639 GREENBAY DR
City DAYTON
State OH
ZIP 45415
Phone 937 397-3600
CertificateType 4
CertificateEffectiveDate 2/9/2024
CertificateExpirationDate 2/8/2026
FacilityType Waiver

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