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07D2197824 CLIA NUMBER - WATERMARK AT HOME ASSISTED LIVING FACILITY

Laboratory Demographics

CLIA Number: 07D2197824

Facility Name: WATERMARK AT HOME ASSISTED LIVING FACILITY

Facility Address:
3030 PARK AVE
BRIDGEPORT, CT
ZIP 06604
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Facility Phone Number: 203 373-6113

Facility Type: Assisted Living Facility

Certificate Type: Waiver
NPI Number: 1275704462

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 07D2197824
LAB Type Assisted Living Facility
Facility Name WATERMARK AT HOME ASSISTED LIVING FACILITY
Street 3030 PARK AVE
City BRIDGEPORT
State CT
ZIP 06604
Phone 203 373-6113
CertificateType 4
CertificateEffectiveDate 10/28/2022
CertificateExpirationDate 10/27/2024
FacilityType Waiver

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