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05D2087574 CLIA NUMBER - FENTON VILLA, INC.

Laboratory Demographics

CLIA Number: 05D2087574

Facility Name: FENTON VILLA, INC.

Facility Address:
13863 FENTON AVE
SYLMAR, CA
ZIP 91342
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Facility Phone Number: 818 350-1169

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1750634903

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 05D2087574
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FENTON VILLA, INC.
Street 13863 FENTON AVE
City SYLMAR
State CA
ZIP 91342
Phone 818 350-1169
CertificateType 4
CertificateEffectiveDate 12/1/2022
CertificateExpirationDate 11/30/2024
FacilityType Waiver

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