01D1091692 CLIA NUMBER - DBA CENTERWELL HOME HEALTH MID-SOUTH HOME HEALTH, LLC

Laboratory Demographics

CLIA Number: 01D1091692

Facility Name: DBA CENTERWELL HOME HEALTH MID-SOUTH HOME HEALTH, LLC

Facility Address:
614 MARTIN ST NORTH
PELL CITY, AL
ZIP 35125
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Facility Phone Number: 205 338-8440

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1366693368

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	01D1091692
LAB Type	Home Health Agency
Facility Name	DBA CENTERWELL HOME HEALTH MID-SOUTH HOME HEALTH, LLC
Street	614 MARTIN ST NORTH
City	PELL CITY
State	AL
ZIP	35125
Phone	205 338-8440
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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