45D1057531 CLIA NUMBER - HEAVENLY HOST INC

Laboratory Demographics

  • CLIA Code: 45D1057531
  • Facility Name: HEAVENLY HOST INC
  • Facility Address: 536 S BRYAN-BELT LINE ROAD
    MESQUITE, TX
    ZIP 75149
  • Facility Phone: 972 289-3800
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: VIJI N. ANTONY
  • NPI Number: 1093738379
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D1057531
LAB Type Home Health Agency
Facility Name HEAVENLY HOST INC
Street 536 S BRYAN-BELT LINE ROAD
City MESQUITE
State TX
ZIP 75149
Phone 972 289-3800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Home Health Agency
Lab Director VIJI N. ANTONY

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