45D1062709 CLIA NUMBER - FORTUNE HEALTHCARE, INC

Laboratory Demographics

CLIA Number: 45D1062709

Facility Name: FORTUNE HEALTHCARE, INC

Facility Address:
2825 WILCREST DR, STE 312
HOUSTON, TX
ZIP 77042
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Facility Phone Number: 713 206-4031

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1326425505

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	45D1062709
LAB Type	Home Health Agency
Facility Name	FORTUNE HEALTHCARE, INC
Street	2825 WILCREST DR, STE 312
City	HOUSTON
State	TX
ZIP	77042
Phone	713 206-4031
CertificateType	4
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	Waiver

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