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05D2190145 CLIA NUMBER - MAYANE CONGREGATE LIVING

Laboratory Demographics

CLIA Number: 05D2190145

Facility Name: MAYANE CONGREGATE LIVING

Facility Address:
17227 SIMONDS STREET
GRANADA HILLS, CA
ZIP 91344
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Facility Phone Number: 818 488-1982

Facility Type: Other - CLHF

Certificate Type: Waiver
NPI Number: 1194231605

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 05D2190145
LAB Type Other - CLHF
Facility Name MAYANE CONGREGATE LIVING
Street 17227 SIMONDS STREET
City GRANADA HILLS
State CA
ZIP 91344
Phone 818 488-1982
CertificateType 4
CertificateEffectiveDate 8/10/2022
CertificateExpirationDate 8/9/2024
FacilityType Waiver

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