04D0677483 CLIA NUMBER - RANDOLPH COUNTY NURSING HOME

Laboratory Demographics

CLIA Number: 04D0677483

Facility Name: RANDOLPH COUNTY NURSING HOME

Facility Address:
500 CAMP ROAD
POCAHONTAS, AR
ZIP 72455
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Facility Phone Number: 870 892-5214

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1750435426

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	04D0677483
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	RANDOLPH COUNTY NURSING HOME
Street	500 CAMP ROAD
City	POCAHONTAS
State	AR
ZIP	72455
Phone	870 892-5214
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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