18D0894620 CLIA NUMBER - PROFESSIONAL HHA

Laboratory Demographics

CLIA Number: 18D0894620

Facility Name: PROFESSIONAL HHA

Facility Address:
4934 SOUTH LAUREL ROAD
LONDON, KY
ZIP 40744
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Facility Phone Number: 606 523-0432

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1912995127

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	18D0894620
LAB Type	Home Health Agency
Facility Name	PROFESSIONAL HHA
Street	4934 SOUTH LAUREL ROAD
City	LONDON
State	KY
ZIP	40744
Phone	606 523-0432
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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