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39D2012604 CLIA NUMBER - AT HOME REHAB

Laboratory Demographics

CLIA Number: 39D2012604

Facility Name: AT HOME REHAB

Facility Address:
542 STREET ROAD
SOUTHAMPTON, PA
ZIP 18966
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Facility Phone Number: 215 230-4140

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1720082290

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 39D2012604
LAB Type Home Health Agency
Facility Name AT HOME REHAB
Street 542 STREET ROAD
City SOUTHAMPTON
State PA
ZIP 18966
Phone 215 230-4140
CertificateType 4
CertificateEffectiveDate 9/8/2022
CertificateExpirationDate 9/7/2024
FacilityType Waiver

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