10D0278192 CLIA NUMBER - MEMORIAL MANOR

Laboratory Demographics

CLIA Number: 10D0278192

Facility Name: MEMORIAL MANOR

Facility Address:
777 S DOUGLAS RD
PEMBROKE PINES, FL
ZIP 33025
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Facility Phone Number: 954 431-1100

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1114920584

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	10D0278192
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	MEMORIAL MANOR
Street	777 S DOUGLAS RD
City	PEMBROKE PINES
State	FL
ZIP	33025
Phone	954 431-1100
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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