45D1050058 CLIA NUMBER - PREMIER GOLDEN HEART HEALTHCARE SERVICES

Laboratory Demographics

CLIA Number: 45D1050058

Facility Name: PREMIER GOLDEN HEART HEALTHCARE SERVICES

Facility Address:
2412 OLD NORTH RD STE 101 K
DENTON, TX
ZIP 76209
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Facility Phone Number: 940 566-4999

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1033279252

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	45D1050058
LAB Type	Home Health Agency
Facility Name	PREMIER GOLDEN HEART HEALTHCARE SERVICES
Street	2412 OLD NORTH RD STE 101 K
City	DENTON
State	TX
ZIP	76209
Phone	940 566-4999
CertificateType	4
CertificateEffectiveDate	1/24/2024
CertificateExpirationDate	1/23/2026
FacilityType	Waiver

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