45D0928279 CLIA NUMBER - CRYSTALCARE HOME HEALTH SERVICES INC

Laboratory Demographics

  • CLIA Code: 45D0928279
  • Facility Name: CRYSTALCARE HOME HEALTH SERVICES INC
  • Facility Address: 1675 REPUBLIC PARKWAY,SUITE 200
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 972 203-2121
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KEYNA N. OMENUKOR
  • NPI Number: 1639383649
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D0928279
LAB Type Home Health Agency
Facility Name CRYSTALCARE HOME HEALTH SERVICES INC
Street 1675 REPUBLIC PARKWAY,SUITE 200
City MESQUITE
State TX
ZIP 75150
Phone 972 203-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Home Health Agency
Lab Director KEYNA N. OMENUKOR

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