Healther Providers Data Logo

14D0716578 CLIA NUMBER - OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES

Laboratory Demographics

CLIA Number: 14D0716578

Facility Name: OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES

Facility Address:
530 NE GLEN OAK AVE - STE 1141
PEORIA, IL
ZIP 61637
Get Directions

Facility Phone Number: 309 624-2480

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver
NPI Number: 1295370039

Taxonomy: 273R00000X - Psychiatric Unit
In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.

CLIA Record

Field Name Field Value
CLIA Number 14D0716578
LAB Type Ancillary Testing Site in Health Care Center
Facility Name OSF HEALTHCARE CHILDREN'S HOSP OF IL PEDS DIABETES
Street 530 NE GLEN OAK AVE - STE 1141
City PEORIA
State IL
ZIP 61637
Phone 309 624-2480
CertificateType 4
CertificateEffectiveDate 1/7/2024
CertificateExpirationDate 1/6/2026
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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