36D2240336 CLIA NUMBER - PEACEFUL HOME HEALTHCARE LLC

Laboratory Demographics

CLIA Number: 36D2240336

Facility Name: PEACEFUL HOME HEALTHCARE LLC

Facility Address:
2021 E DUBLIN GRANVILLE RD
COLUMBUS, OH
ZIP 43229
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Facility Phone Number: 614 845-7684

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1811261571

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	36D2240336
LAB Type	Home Health Agency
Facility Name	PEACEFUL HOME HEALTHCARE LLC
Street	2021 E DUBLIN GRANVILLE RD
City	COLUMBUS
State	OH
ZIP	43229
Phone	614 845-7684
CertificateType	4
CertificateEffectiveDate	10/19/2023
CertificateExpirationDate	10/18/2025
FacilityType	Waiver

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