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14D2046182 CLIA NUMBER - RESIDENTIAL HOSPICE RESIDENTIAL HOSPICE ILLINOIS, L L C

Laboratory Demographics

CLIA Number: 14D2046182

Facility Name: RESIDENTIAL HOSPICE RESIDENTIAL HOSPICE ILLINOIS, L L C

Facility Address:
2443 WARRENVILLE RD - STE 500
LISLE, IL
ZIP 60532
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Facility Phone Number: 866 902-5100

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1851351233

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 14D2046182
LAB Type Hospice
Facility Name RESIDENTIAL HOSPICE RESIDENTIAL HOSPICE ILLINOIS, L L C
Street 2443 WARRENVILLE RD - STE 500
City LISLE
State IL
ZIP 60532
Phone 866 902-5100
CertificateType 4
CertificateEffectiveDate 8/28/2022
CertificateExpirationDate 8/27/2024
FacilityType Waiver

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