45D1041564 CLIA NUMBER - BLOSSOM HOME HEALTHCARE SERVICES

Laboratory Demographics

  • CLIA Code: 45D1041564
  • Facility Name: BLOSSOM HOME HEALTHCARE SERVICES
  • Facility Address: 12959 JUPITER RD #253
    DALLAS, TX
    ZIP 75238
  • Facility Phone: (469) 906-6359
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: UKACHI AKOGU
  • NPI Number: 1396320289
  • Taxonomy: 251E00000X - Home Health

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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 4699066359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Home Health Agency
Lab Director UKACHI AKOGU

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This page was last updated on: 5/18/2026