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05D0916428 CLIA NUMBER - BALBOA NURSING AND REHABILITATION CENTER

Laboratory Demographics

CLIA Number: 05D0916428

Facility Name: BALBOA NURSING AND REHABILITATION CENTER

Facility Address:
3520 4TH AVENUE
SAN DIEGO, CA
ZIP 92103
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Facility Phone Number: 619 291-5270

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1578521274

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 05D0916428
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BALBOA NURSING AND REHABILITATION CENTER
Street 3520 4TH AVENUE
City SAN DIEGO
State CA
ZIP 92103
Phone 619 291-5270
CertificateType 4
CertificateEffectiveDate 6/21/2022
CertificateExpirationDate 6/20/2024
FacilityType Waiver

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