45D1053203 CLIA NUMBER - ULTIMATE HOME HEALTH CARE

Laboratory Demographics

  • CLIA Code: 45D1053203
  • Facility Name: ULTIMATE HOME HEALTH CARE
  • Facility Address: 4402 BROADWAY BLVD, SUITE 14
    GARLAND, TX
    ZIP 75043
  • Facility Phone: 972 240-8700
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MERCY G. JOHNSON
  • NPI Number: 1750778197
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D1053203
LAB Type Home Health Agency
Facility Name ULTIMATE HOME HEALTH CARE
Street 4402 BROADWAY BLVD, SUITE 14
City GARLAND
State TX
ZIP 75043
Phone 972 240-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Home Health Agency
Lab Director MERCY G. JOHNSON

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