24D0688130 CLIA NUMBER - GOOD SAMARITAN SOCIETY WACONIA

Laboratory Demographics

CLIA Number: 24D0688130

Facility Name: GOOD SAMARITAN SOCIETY WACONIA

Facility Address:
333 WEST 5TH STREET
WACONIA, MN
ZIP 55387
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Facility Phone Number: 952 442-5111

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1235110081

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	24D0688130
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	GOOD SAMARITAN SOCIETY WACONIA
Street	333 WEST 5TH STREET
City	WACONIA
State	MN
ZIP	55387
Phone	952 442-5111
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