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34D0715567 CLIA NUMBER - INTERIM HEALTHCARE OF THE TRIAD, INC

Laboratory Demographics

CLIA Number: 34D0715567

Facility Name: INTERIM HEALTHCARE OF THE TRIAD, INC

Facility Address:
3325 HEALY DRIVE, SUITE C
WINSTON SALEM, NC
ZIP 27103
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Facility Phone Number: 336 768-6997

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1124235270

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 34D0715567
LAB Type Home Health Agency
Facility Name INTERIM HEALTHCARE OF THE TRIAD, INC
Street 3325 HEALY DRIVE, SUITE C
City WINSTON SALEM
State NC
ZIP 27103
Phone 336 768-6997
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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