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17D0863841 CLIA NUMBER - KIOWA HOSPITAL DISTRICT MANOR

Laboratory Demographics

CLIA Number: 17D0863841

Facility Name: KIOWA HOSPITAL DISTRICT MANOR

Facility Address:
1020 MAIN PO BOX 103
KIOWA, KS
ZIP 67070
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Facility Phone Number: 620 825-4117

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1043273378

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name Field Value
CLIA Number 17D0863841
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name KIOWA HOSPITAL DISTRICT MANOR
Street 1020 MAIN PO BOX 103
City KIOWA
State KS
ZIP 67070
Phone 620 825-4117
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