01D0678837 CLIA NUMBER - MADISON MANOR NURSING HOME

Laboratory Demographics

CLIA Number: 01D0678837

Facility Name: MADISON MANOR NURSING HOME

Facility Address:
3891 SULLIVAN STREET
MADISON, AL
ZIP 35758
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Facility Phone Number: (256) 772-9243

Facility Type: SKILLED NURSING/NURSING FACILITY

Certificate Type: Waiver

NPI Number: 1033178504

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name	Field Value
CLIA Number	01D0678837
LAB Type	SKILLED NURSING/NURSING FACILITY
Facility Name	MADISON MANOR NURSING HOME
Street	3891 SULLIVAN STREET
City	MADISON
State	AL
ZIP	35758
Phone	(256) 772-9243

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This page was last updated on: 5/11/2023