Healther Providers Data Logo

03D0682546 CLIA NUMBER - LIFESTREAM COMPLETE SENIOR LIVING AT COOK HEALTH CARE

Laboratory Demographics

CLIA Number: 03D0682546

Facility Name: LIFESTREAM COMPLETE SENIOR LIVING AT COOK HEALTH CARE

Facility Address:
11527 W PEORIA AVE
YOUNGTOWN, AZ
ZIP 85363
Get Directions

Facility Phone Number: 623 933-4683

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1447256466

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name Field Value
CLIA Number 03D0682546
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIFESTREAM COMPLETE SENIOR LIVING AT COOK HEALTH CARE
Street 11527 W PEORIA AVE
City YOUNGTOWN
State AZ
ZIP 85363
Phone 623 933-4683
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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