11D0257557 CLIA NUMBER - LIFE CARE CENTER OF GWINNETT

Laboratory Demographics

CLIA Number: 11D0257557

Facility Name: LIFE CARE CENTER OF GWINNETT

Facility Address:
3850 SAFEHAVEN DRIVE
LAWRENCEVILLE, GA
ZIP 30044
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Facility Phone Number: 770 923-0005

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1295768950

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	11D0257557
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	LIFE CARE CENTER OF GWINNETT
Street	3850 SAFEHAVEN DRIVE
City	LAWRENCEVILLE
State	GA
ZIP	30044
Phone	770 923-0005
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