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25D0906490 CLIA NUMBER - DIVERSICARE OF QUITMAN

Laboratory Demographics

CLIA Number: 25D0906490

Facility Name: DIVERSICARE OF QUITMAN

Facility Address:
191 HWY 511 E
QUITMAN, MS
ZIP 39355
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Facility Phone Number: 601 776-2141

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1780676049

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 25D0906490
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name DIVERSICARE OF QUITMAN
Street 191 HWY 511 E
City QUITMAN
State MS
ZIP 39355
Phone 601 776-2141
CertificateType 4
CertificateEffectiveDate 10/2/2023
CertificateExpirationDate 10/1/2025
FacilityType Waiver

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