05D0606722 CLIA NUMBER - DRIFTWOOD CONVALESCENT

Laboratory Demographics

CLIA Number: 05D0606722

Facility Name: DRIFTWOOD CONVALESCENT

Facility Address:
675 24TH AVENUE
SANTA CRUZ, CA
ZIP 95062
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Facility Phone Number: 408 475-6323

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1548232150

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name	Field Value
CLIA Number	05D0606722
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	DRIFTWOOD CONVALESCENT
Street	675 24TH AVENUE
City	SANTA CRUZ
State	CA
ZIP	95062
Phone	408 475-6323
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