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11D2194798 CLIA NUMBER - BAPTIST VILLAGE, INC DBA VILLAGE LAKE SUITES

Laboratory Demographics

CLIA Number: 11D2194798

Facility Name: BAPTIST VILLAGE, INC DBA VILLAGE LAKE SUITES

Facility Address:
715 VILLAGE LAKE DRIVE
WAYCROSS, GA
ZIP 31503
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Facility Phone Number: 912 287-9977

Facility Type: Other - PERSONAL CARE HOME

Certificate Type: Waiver
NPI Number: 1548242837

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 11D2194798
LAB Type Other - PERSONAL CARE HOME
Facility Name BAPTIST VILLAGE, INC DBA VILLAGE LAKE SUITES
Street 715 VILLAGE LAKE DRIVE
City WAYCROSS
State GA
ZIP 31503
Phone 912 287-9977
CertificateType 4
CertificateEffectiveDate 10/2/2022
CertificateExpirationDate 10/1/2024
FacilityType Waiver

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