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01D0888819 CLIA NUMBER - WEST GATE VILLAGE INC

Laboratory Demographics

CLIA Number: 01D0888819

Facility Name: WEST GATE VILLAGE INC

Facility Address:
100 PINEVIEW STREET
BREWTON, AL
ZIP 36426
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Facility Phone Number: 251 867-6077

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1144289711

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 01D0888819
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WEST GATE VILLAGE INC
Street 100 PINEVIEW STREET
City BREWTON
State AL
ZIP 36426
Phone 251 867-6077
CertificateType 4
CertificateEffectiveDate 7/14/2022
CertificateExpirationDate 7/13/2024
FacilityType Waiver

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