34D0715569 CLIA NUMBER - INTERIM HEALTHCARE OF THE TRIAD

Laboratory Demographics

CLIA Number: 34D0715569

Facility Name: INTERIM HEALTHCARE OF THE TRIAD

Facility Address:
200 1ST AVENUE NW STE 314
HICKORY, NC
ZIP 28601
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Facility Phone Number: 828 324-2121

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1255548301

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	34D0715569
LAB Type	Home Health Agency
Facility Name	INTERIM HEALTHCARE OF THE TRIAD
Street	200 1ST AVENUE NW STE 314
City	HICKORY
State	NC
ZIP	28601
Phone	828 324-2121
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