14D0859355 CLIA NUMBER - CARDIO-CARE HOME HEALTH AGENCY

Laboratory Demographics

CLIA Number: 14D0859355

Facility Name: CARDIO-CARE HOME HEALTH AGENCY

Facility Address:
5917 N LINCOLN AVE
CHICAGO, IL
ZIP 60659
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Facility Phone Number: 312 989-8117

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1164423661

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	14D0859355
LAB Type	Home Health Agency
Facility Name	CARDIO-CARE HOME HEALTH AGENCY
Street	5917 N LINCOLN AVE
City	CHICAGO
State	IL
ZIP	60659
Phone	312 989-8117
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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