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45D0920719 CLIA NUMBER - HERITAGE HOMECARE

Laboratory Demographics

CLIA Number: 45D0920719

Facility Name: HERITAGE HOMECARE

Facility Address:
402 WEST WHEATLAND ROAD,SUITE 170
DUNCANVILLE, TX
ZIP 75116
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Facility Phone Number: 972 283-8124

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1093885212

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 45D0920719
LAB Type Home Health Agency
Facility Name HERITAGE HOMECARE
Street 402 WEST WHEATLAND ROAD,SUITE 170
City DUNCANVILLE
State TX
ZIP 75116
Phone 972 283-8124
CertificateType 4
CertificateEffectiveDate 10/9/2022
CertificateExpirationDate 10/8/2024
FacilityType Waiver

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