14D2097509 CLIA NUMBER - PEARL PAVILION

Laboratory Demographics

CLIA Number: 14D2097509

Facility Name: PEARL PAVILION

Facility Address:
900 S KIWANIS DR
FREEPORT, IL
ZIP 61032
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Facility Phone Number: 815 235-6196

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1861871246

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 14D2097509
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PEARL PAVILION
Street 900 S KIWANIS DR
City FREEPORT
State IL
ZIP 61032
Phone 815 235-6196
CertificateType 4
CertificateEffectiveDate 6/17/2023
CertificateExpirationDate 6/16/2025
FacilityType Waiver

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