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46D1010925 CLIA NUMBER - CAREGIVER SUPPORT NETWORK

Laboratory Demographics

CLIA Number: 46D1010925

Facility Name: CAREGIVER SUPPORT NETWORK

Facility Address:
404 EAST 4500 SOUTH, SUITE A24
MURRAY, UT
ZIP 84107
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Facility Phone Number: 801 747-2100

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1083610869

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 46D1010925
LAB Type Home Health Agency
Facility Name CAREGIVER SUPPORT NETWORK
Street 404 EAST 4500 SOUTH, SUITE A24
City MURRAY
State UT
ZIP 84107
Phone 801 747-2100
CertificateType 4
CertificateEffectiveDate 3/27/2023
CertificateExpirationDate 3/26/2025
FacilityType Waiver

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