14D1017706 CLIA NUMBER - MEDTEC HOME HEALTH AGENCY INC

Laboratory Demographics

CLIA Number: 14D1017706

Facility Name: MEDTEC HOME HEALTH AGENCY INC

Facility Address:
10001 ROOSEVELT RD - STE 306
WESTCHESTER, IL
ZIP 60154
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Facility Phone Number: 708 681-2009

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1548375447

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 14D1017706
LAB Type Home Health Agency
Facility Name MEDTEC HOME HEALTH AGENCY INC
Street 10001 ROOSEVELT RD - STE 306
City WESTCHESTER
State IL
ZIP 60154
Phone 708 681-2009
CertificateType 4
CertificateEffectiveDate 10/2/2023
CertificateExpirationDate 10/1/2025
FacilityType Waiver

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