45D2212024 CLIA NUMBER - CC YOUNG ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 45D2212024

Facility Name: CC YOUNG ASSISTED LIVING

Facility Address:
4847 W LAWTHER DR
DALLAS, TX
ZIP 75214
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Facility Phone Number: 214 841-2943

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1326231499

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	45D2212024
LAB Type	Assisted Living Facility
Facility Name	CC YOUNG ASSISTED LIVING
Street	4847 W LAWTHER DR
City	DALLAS
State	TX
ZIP	75214
Phone	214 841-2943
CertificateType	4
CertificateEffectiveDate	2/2/2023
CertificateExpirationDate	2/1/2025
FacilityType	Waiver

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