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34D0881501 CLIA NUMBER - LIBERTY HOME CARE II, LLC - RAEFORD

Laboratory Demographics

CLIA Number: 34D0881501

Facility Name: LIBERTY HOME CARE II, LLC - RAEFORD

Facility Address:
336 S MAIN STREET
RAEFORD, NC
ZIP 28376
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Facility Phone Number: 919 875-8198

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1407801749

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 34D0881501
LAB Type Home Health Agency
Facility Name LIBERTY HOME CARE II, LLC - RAEFORD
Street 336 S MAIN STREET
City RAEFORD
State NC
ZIP 28376
Phone 919 875-8198
CertificateType 4
CertificateEffectiveDate 1/11/2024
CertificateExpirationDate 1/10/2026
FacilityType Waiver

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