05D0564372 CLIA NUMBER - POMONA VISTA CARE CENTER

Laboratory Demographics

CLIA Number: 05D0564372

Facility Name: POMONA VISTA CARE CENTER

Facility Address:
651 N MAIN ST
POMONA, CA
ZIP 91768
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Facility Phone Number: 909 623-2481

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1639334006

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	05D0564372
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	POMONA VISTA CARE CENTER
Street	651 N MAIN ST
City	POMONA
State	CA
ZIP	91768
Phone	909 623-2481
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