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10D0878407 CLIA NUMBER - WILLOW BROOKE COURT AT AZALEA TRACE

Laboratory Demographics

CLIA Number: 10D0878407

Facility Name: WILLOW BROOKE COURT AT AZALEA TRACE

Facility Address:
10100 HILLVIEW ROAD
PENSACOLA, FL
ZIP 32514
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Facility Phone Number: 850 857-4931

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1396772109

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 10D0878407
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLOW BROOKE COURT AT AZALEA TRACE
Street 10100 HILLVIEW ROAD
City PENSACOLA
State FL
ZIP 32514
Phone 850 857-4931
CertificateType 4
CertificateEffectiveDate 10/26/2023
CertificateExpirationDate 10/25/2025
FacilityType Waiver

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