05D0687589 CLIA NUMBER - PRUITTHEALTH - SUNRISE, LLC

Laboratory Demographics

CLIA Number: 05D0687589

Facility Name: PRUITTHEALTH - SUNRISE, LLC

Facility Address:
2709 SOUTH MAIN STREET
MOULTRIE, GA
ZIP 31768
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Facility Phone Number: 229 985-7173

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1629025150

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	05D0687589
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PRUITTHEALTH - SUNRISE, LLC
Street	2709 SOUTH MAIN STREET
City	MOULTRIE
State	GA
ZIP	31768
Phone	229 985-7173
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