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44D0902252 CLIA NUMBER - FC OF TENNESSEE INC D/B/A INTREPID USA HEALTHCARE SERVICES

Laboratory Demographics

CLIA Number: 44D0902252

Facility Name: FC OF TENNESSEE INC D/B/A INTREPID USA HEALTHCARE SERVICES

Facility Address:
2763 SUMMER OAKS DRIVE, SUITE 101
MEMPHIS, TN
ZIP 38134
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Facility Phone Number: 901 213-0285

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1821071929

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 44D0902252
LAB Type Home Health Agency
Facility Name FC OF TENNESSEE INC D/B/A INTREPID USA HEALTHCARE SERVICES
Street 2763 SUMMER OAKS DRIVE, SUITE 101
City MEMPHIS
State TN
ZIP 38134
Phone 901 213-0285
CertificateType 4
CertificateEffectiveDate 6/16/2023
CertificateExpirationDate 6/15/2025
FacilityType Waiver

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