05D2188433 CLIA NUMBER - GOLDEN STATE HOMES INC

Laboratory Demographics

CLIA Number: 05D2188433

Facility Name: GOLDEN STATE HOMES INC

Facility Address:
1409 N NORMANDIE AVE
LOS ANGELES, CA
ZIP 90027
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Facility Phone Number: 323 230-4488

Facility Type: Other - CONGREGATE FACILITY

Certificate Type: Waiver

NPI Number: 1932658010

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	05D2188433
LAB Type	Other - CONGREGATE FACILITY
Facility Name	GOLDEN STATE HOMES INC
Street	1409 N NORMANDIE AVE
City	LOS ANGELES
State	CA
ZIP	90027
Phone	323 230-4488
CertificateType	4
CertificateEffectiveDate	7/16/2022
CertificateExpirationDate	7/15/2024
FacilityType	Waiver

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