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14D1054944 CLIA NUMBER - CHOICE HOME HEALTH SERVICE INC

Laboratory Demographics

CLIA Number: 14D1054944

Facility Name: CHOICE HOME HEALTH SERVICE INC

Facility Address:
5765 N LINCOLN AVE - STE 21
CHICAGO, IL
ZIP 60659
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Facility Phone Number: 773 290-1333

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1558462630

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 14D1054944
LAB Type Home Health Agency
Facility Name CHOICE HOME HEALTH SERVICE INC
Street 5765 N LINCOLN AVE - STE 21
City CHICAGO
State IL
ZIP 60659
Phone 773 290-1333
CertificateType 4
CertificateEffectiveDate 6/6/2022
CertificateExpirationDate 6/5/2024
FacilityType Waiver

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