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18D1070308 CLIA NUMBER - LIFELINE HOME HEALTH CARE OF FULTON,LLC DBA LIFELINE HEALTH CARE OF FULTON

Laboratory Demographics

CLIA Number: 18D1070308

Facility Name: LIFELINE HOME HEALTH CARE OF FULTON,LLC DBA LIFELINE HEALTH CARE OF FULTON

Facility Address:
309 MAIN STREET
FULTON, KY
ZIP 42041
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Facility Phone Number: 270 472-2294

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1740404540

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 18D1070308
LAB Type Home Health Agency
Facility Name LIFELINE HOME HEALTH CARE OF FULTON,LLC DBA LIFELINE HEALTH CARE OF FULTON
Street 309 MAIN STREET
City FULTON
State KY
ZIP 42041
Phone 270 472-2294
CertificateType 4
CertificateEffectiveDate 6/26/2023
CertificateExpirationDate 6/25/2025
FacilityType Waiver

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