45D0919833 CLIA NUMBER - HEALTHSOURCE HOME CARE INC

Laboratory Demographics

  • CLIA Code: 45D0919833
  • Facility Name: HEALTHSOURCE HOME CARE INC
  • Facility Address: 5709 DOLORES STREET
    HOUSTON, TX
    ZIP 77057
  • Facility Phone: 713 592-5364
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: LEJEUNE HOLCOMBE
  • NPI Number: 1669491874
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D0919833
LAB Type Home Health Agency
Facility Name HEALTHSOURCE HOME CARE INC
Street 5709 DOLORES STREET
City HOUSTON
State TX
ZIP 77057
Phone 713 592-5364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Home Health Agency
Lab Director LEJEUNE HOLCOMBE

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