33D2245038 CLIA NUMBER - NORTHERN LIGHTS HOME HEALTH CARE

Laboratory Demographics

CLIA Number: 33D2245038

Facility Name: NORTHERN LIGHTS HOME HEALTH CARE

Facility Address:
91 MAIN ST
CANTON, NY
ZIP 13617
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Facility Phone Number: 315 714-3135

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1659731388

Taxonomy: 335E00000X - Prosthetic/Orthotic Supplier
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

CLIA Record

Field Name	Field Value
CLIA Number	33D2245038
LAB Type	Home Health Agency
Facility Name	NORTHERN LIGHTS HOME HEALTH CARE
Street	91 MAIN ST
City	CANTON
State	NY
ZIP	13617
Phone	315 714-3135
CertificateType	4
CertificateEffectiveDate	12/8/2021
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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