14D1094439 CLIA NUMBER - MEDERI CARETENDERS CROSSROADS HOME CARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 14D1094439
  • Facility Name: MEDERI CARETENDERS CROSSROADS HOME CARE SERVICES, LLC
  • Facility Address: 4112 NORTH WATER TOWER PLACE - STE A
    MOUNT VERNON, IL
    ZIP 62864
  • Facility Phone: 618 988-1840
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: RACHEL STRAND
  • NPI Number: 1225327356
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 14D1094439
LAB Type Home Health Agency
Facility Name MEDERI CARETENDERS CROSSROADS HOME CARE SERVICES, LLC
Street 4112 NORTH WATER TOWER PLACE - STE A
City MOUNT VERNON
State IL
ZIP 62864
Phone 618 988-1840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Home Health Agency
Lab Director RACHEL STRAND

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