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23D1014287 CLIA NUMBER - HEARTLAND HOSPICE SERVICES LLC DBA PROMEDICA HOSPICE KALAMAZOO

Laboratory Demographics

CLIA Number: 23D1014287

Facility Name: HEARTLAND HOSPICE SERVICES LLC DBA PROMEDICA HOSPICE KALAMAZOO

Facility Address:
8075 CREEKSIDE DRIVE SUITE 120
PORTAGE, MI
ZIP 49024
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Facility Phone Number: 269 324-5705

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1336192434

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 23D1014287
LAB Type Hospice
Facility Name HEARTLAND HOSPICE SERVICES LLC DBA PROMEDICA HOSPICE KALAMAZOO
Street 8075 CREEKSIDE DRIVE SUITE 120
City PORTAGE
State MI
ZIP 49024
Phone 269 324-5705
CertificateType 4
CertificateEffectiveDate 7/1/2023
CertificateExpirationDate 6/30/2025
FacilityType Waiver

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