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37D2272100 CLIA NUMBER - ELMBROOK AT HOME, LLC

Laboratory Demographics

CLIA Number: 37D2272100

Facility Name: ELMBROOK AT HOME, LLC

Facility Address:
1908 12TH AVE NW, STE E
ARDMORE, OK
ZIP 73401
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Facility Phone Number: 580 226-3055

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1275532616

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name Field Value
CLIA Number 37D2272100
LAB Type Home Health Agency
Facility Name ELMBROOK AT HOME, LLC
Street 1908 12TH AVE NW, STE E
City ARDMORE
State OK
ZIP 73401
Phone 580 226-3055
CertificateType 4
CertificateEffectiveDate 11/15/2022
CertificateExpirationDate 11/14/2024
FacilityType Waiver

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