14D1067285 CLIA NUMBER - PRIME HOME CARE - KANKAKEE PRIME HEALTHCARE HOME CARE & HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 14D1067285
  • Facility Name: PRIME HOME CARE - KANKAKEE PRIME HEALTHCARE HOME CARE & HOSPICE LLC
  • Facility Address: 555 W COURT ST - STE 212
    KANKAKEE, IL
    ZIP 60901
  • Facility Phone: 815 937-2475
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: GAYLE MELBY
  • NPI Number: 1134178338
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 14D1067285
LAB Type Home Health Agency
Facility Name PRIME HOME CARE - KANKAKEE PRIME HEALTHCARE HOME CARE & HOSPICE LLC
Street 555 W COURT ST - STE 212
City KANKAKEE
State IL
ZIP 60901
Phone 815 937-2475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Home Health Agency
Lab Director GAYLE MELBY

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This page was last updated on: 9/29/2025