50D2274417 CLIA NUMBER - WELLSPRING HOME HEALTH CENTER, LLC

Laboratory Demographics

CLIA Number: 50D2274417

Facility Name: WELLSPRING HOME HEALTH CENTER, LLC

Facility Address:
8815 S TACOMA WAY STE 120
LAKEWOOD, WA
ZIP 98499
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Facility Phone Number: 253 625-7606

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1801429733

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 50D2274417
LAB Type Home Health Agency
Facility Name WELLSPRING HOME HEALTH CENTER, LLC
Street 8815 S TACOMA WAY STE 120
City LAKEWOOD
State WA
ZIP 98499
Phone 253 625-7606
CertificateType 4
CertificateEffectiveDate 1/4/2023
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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