14D2020229 CLIA NUMBER - PLATINUM HEALTH CARE SERVICES LLC

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Laboratory Demographics

CLIA Number: 14D2020229

Facility Name: PLATINUM HEALTH CARE SERVICES LLC

Facility Address:
1420 RENAISSANCE DR - STE 207
PARK RIDGE, IL
ZIP 60068
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Facility Phone Number: 224 251-7930

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1801125539

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	14D2020229
LAB Type	Home Health Agency
Facility Name	PLATINUM HEALTH CARE SERVICES LLC
Street	1420 RENAISSANCE DR - STE 207
City	PARK RIDGE
State	IL
ZIP	60068
Phone	224 251-7930
CertificateType	4
CertificateEffectiveDate	2/15/2023
CertificateExpirationDate	2/14/2025
FacilityType	Waiver

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