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52D0884948 CLIA NUMBER - INTERIM HEALTHCARE OF WISCONSIN

Laboratory Demographics

CLIA Number: 52D0884948

Facility Name: INTERIM HEALTHCARE OF WISCONSIN

Facility Address:
2801 COHO ST, STE 302
MADISON, WI
ZIP 53713
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Facility Phone Number: 608 238-0268

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1144518648

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 52D0884948
LAB Type Home Health Agency
Facility Name INTERIM HEALTHCARE OF WISCONSIN
Street 2801 COHO ST, STE 302
City MADISON
State WI
ZIP 53713
Phone 608 238-0268
CertificateType 4
CertificateEffectiveDate 4/13/2024
CertificateExpirationDate 4/12/2026
FacilityType Waiver

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