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03D2112563 CLIA NUMBER - KINGMAN HOSPITAL, INC DBA KINGMAN REGIONAL MEDICAL

Laboratory Demographics

CLIA Number: 03D2112563

Facility Name: KINGMAN HOSPITAL, INC DBA KINGMAN REGIONAL MEDICAL

Facility Address:
3801 SANTA ROSA DR
KINGMAN, AZ
ZIP 86401
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Facility Phone Number: (928) 263-4632

Facility Type: HOSPITAL

Certificate Type: Waiver
NPI Number: 1184802480

Taxonomy: 273Y00000X - Rehabilitation Unit
In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient's condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient's medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services.

CLIA Record

Field Name Field Value
CLIA Number 03D2112563
LAB Type HOSPITAL
Facility Name KINGMAN HOSPITAL, INC DBA KINGMAN REGIONAL MEDICAL
Street 3801 SANTA ROSA DR
City KINGMAN
State AZ
ZIP 86401
Phone (928) 263-4632

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