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50D0711312 CLIA NUMBER - GENTIVA CERITIFIED HEALTHCARE CORP CENTERWELL HOME HEALTH

Laboratory Demographics

CLIA Number: 50D0711312

Facility Name: GENTIVA CERITIFIED HEALTHCARE CORP CENTERWELL HOME HEALTH

Facility Address:
204 SE STONEMILL DR STE 260
VANCOUVER, WA
ZIP 98684
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Facility Phone Number: 360 253-7746

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1205867819

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 50D0711312
LAB Type Home Health Agency
Facility Name GENTIVA CERITIFIED HEALTHCARE CORP CENTERWELL HOME HEALTH
Street 204 SE STONEMILL DR STE 260
City VANCOUVER
State WA
ZIP 98684
Phone 360 253-7746
CertificateType 4
CertificateEffectiveDate 9/1/1992
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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