45D1041564 CLIA NUMBER - BLOSSOM HOME HEALTHCARE SERVICES

Laboratory Demographics

CLIA Number: 45D1041564

Facility Name: BLOSSOM HOME HEALTHCARE SERVICES

Facility Address:
12959 JUPITER RD #253
DALLAS, TX
ZIP 75238
Get Directions

Facility Phone Number: 469 906-6359

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1457497232

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 45D1041564
LAB Type Home Health Agency
Facility Name BLOSSOM HOME HEALTHCARE SERVICES
Street 12959 JUPITER RD #253
City DALLAS
State TX
ZIP 75238
Phone 469 906-6359
CertificateType 4
CertificateEffectiveDate 6/7/2023
CertificateExpirationDate 6/6/2025
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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