45D1074955 CLIA NUMBER - NIGHTINGALE PROVIDER SERVICES INC DBA NIGHTINGALE HOME HEALTH AGENCY

Laboratory Demographics

  • CLIA Code: 45D1074955
  • Facility Name: NIGHTINGALE PROVIDER SERVICES INC DBA NIGHTINGALE HOME HEALTH AGENCY
  • Facility Address: 1405 S FLEISHEL AVE STE 315
    TYLER, TX
    ZIP 75701
  • Facility Phone: 903 509-4440
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JULIUA O. WILLIAMS
  • NPI Number: 1336334515
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D1074955
LAB Type Home Health Agency
Facility Name NIGHTINGALE PROVIDER SERVICES INC DBA NIGHTINGALE HOME HEALTH AGENCY
Street 1405 S FLEISHEL AVE STE 315
City TYLER
State TX
ZIP 75701
Phone 903 509-4440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Home Health Agency
Lab Director JULIUA O. WILLIAMS

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