42D2198404 CLIA NUMBER - HOME INSTEAD SENIOR CARE OF CHARLESTON

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Laboratory Demographics

CLIA Number: 42D2198404

Facility Name: HOME INSTEAD SENIOR CARE OF CHARLESTON

Facility Address:
11 GAMECOCK AVE SUITE 1105
CHARLESTON, SC
ZIP 29407
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Facility Phone Number: 843 571-3000

Facility Type: Other - IN HOME SENIOR CARE PROVI

Certificate Type: Waiver

NPI Number: 1679937361

Taxonomy: 305S00000X - Point of Service
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

CLIA Record

Field Name	Field Value
CLIA Number	42D2198404
LAB Type	Other - IN HOME SENIOR CARE PROVI
Facility Name	HOME INSTEAD SENIOR CARE OF CHARLESTON
Street	11 GAMECOCK AVE SUITE 1105
City	CHARLESTON
State	SC
ZIP	29407
Phone	843 571-3000
CertificateType	4
CertificateEffectiveDate	11/2/2022
CertificateExpirationDate	11/1/2024
FacilityType	Waiver

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