05D0574080 CLIA NUMBER - PLYMOUTH VILLAGE

Laboratory Demographics

CLIA Number: 05D0574080

Facility Name: PLYMOUTH VILLAGE

Facility Address:
819 SALEM DRIVE
REDLANDS, CA
ZIP 92373
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Facility Phone Number: (909) 793-1233

Facility Type: SKILLED NURSING/NURSING FACILITY

Certificate Type: Waiver

NPI Number: 1578550372

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	05D0574080
LAB Type	SKILLED NURSING/NURSING FACILITY
Facility Name	PLYMOUTH VILLAGE
Street	819 SALEM DRIVE
City	REDLANDS
State	CA
ZIP	92373
Phone	(909) 793-1233

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