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05D0895979 CLIA NUMBER - PAVILION ON PICO HEALTHCARE & WELLNESS CENTRE, LP

Laboratory Demographics

CLIA Number: 05D0895979

Facility Name: PAVILION ON PICO HEALTHCARE & WELLNESS CENTRE, LP

Facility Address:
5916 W PICO BLVD
LOS ANGELES, CA
ZIP 90035
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Facility Phone Number: 323 939-3184

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1790041010

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 05D0895979
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PAVILION ON PICO HEALTHCARE & WELLNESS CENTRE, LP
Street 5916 W PICO BLVD
City LOS ANGELES
State CA
ZIP 90035
Phone 323 939-3184
CertificateType 4
CertificateEffectiveDate 1/7/2024
CertificateExpirationDate 1/6/2026
FacilityType Waiver

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