49D2189092 CLIA NUMBER - DIVINE HOME HEALTH, INC

Laboratory Demographics

  • CLIA Code: 49D2189092
  • Facility Name: DIVINE HOME HEALTH, INC
  • Facility Address: 21335 SIGNAL HILL PLAZA, SUITE 250
    STERLING, VA
    ZIP 20164
  • Facility Phone: 571 446-7997
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KANTA TELHAN
  • NPI Number: 1073156527
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 49D2189092
LAB Type Home Health Agency
Facility Name DIVINE HOME HEALTH, INC
Street 21335 SIGNAL HILL PLAZA, SUITE 250
City STERLING
State VA
ZIP 20164
Phone 571 446-7997
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2024
Certificate Expiration Date 7/26/2026
Facility Type Home Health Agency
Lab Director KANTA TELHAN

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