Entity Details

Portable X-Ray ( XRAY )

Basic

Entity Type:
Portable X-ray Services (XRAY)

Former Entity Name:
Portable X-ray

Medicaid #:

CCN #:
169812

Occupancy Type:
Beds

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:
47

Entity Type Survey Cycle(months):
73

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3160 8th Street SW, Suite C

City:
Altoona

State:
Iowa

Zip:
50009-1023

Phone:
(515) 244-2837

Fax:

URL:

Administrator/License #:
Tamera Schwartz /

Administrator Email:
tschwartz@biotechxray.com

Files

Life Safety Code (LSC) Waiver:

No Files Found

Licensure Rule Variance:

No Files Found