14D1068297 CLIA NUMBER - FAITH HOME HEALTHCARE

Laboratory Demographics

CLIA Number: 14D1068297

Facility Name: FAITH HOME HEALTHCARE

Facility Address:
9919 ROOSEVELT ROAD SUITE 204
WESTCHESTER, IL
ZIP 60154
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Facility Phone Number: 708 681-2853

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1225210495

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	14D1068297
LAB Type	Home Health Agency
Facility Name	FAITH HOME HEALTHCARE
Street	9919 ROOSEVELT ROAD SUITE 204
City	WESTCHESTER
State	IL
ZIP	60154
Phone	708 681-2853
CertificateType	4
CertificateEffectiveDate	5/8/2023
CertificateExpirationDate	5/7/2025
FacilityType	Waiver

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