10D0876317 CLIA NUMBER - INTERIM HEALTHCARE

Laboratory Demographics

CLIA Number: 10D0876317

Facility Name: INTERIM HEALTHCARE

Facility Address:
2679 JENKS AVE
PANAMA CITY, FL
ZIP 32405
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Facility Phone Number: 850 747-0080

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1871654210

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	10D0876317
LAB Type	Home Health Agency
Facility Name	INTERIM HEALTHCARE
Street	2679 JENKS AVE
City	PANAMA CITY
State	FL
ZIP	32405
Phone	850 747-0080
CertificateType	4
CertificateEffectiveDate	9/16/2023
CertificateExpirationDate	9/15/2025
FacilityType	Waiver

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