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14D1063551 CLIA NUMBER - CRYSTAL HOME HEALTH CARE L L C

Laboratory Demographics

CLIA Number: 14D1063551

Facility Name: CRYSTAL HOME HEALTH CARE L L C

Facility Address:
2720 S RIVER RD, STE 47
DES PLAINES, IL
ZIP 60018
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Facility Phone Number: 847 257-7620

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1225281520

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 14D1063551
LAB Type Home Health Agency
Facility Name CRYSTAL HOME HEALTH CARE L L C
Street 2720 S RIVER RD, STE 47
City DES PLAINES
State IL
ZIP 60018
Phone 847 257-7620
CertificateType 4
CertificateEffectiveDate 1/17/2023
CertificateExpirationDate 1/16/2025
FacilityType Waiver

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