33D0173383 CLIA NUMBER - ST JOHN'S HEALTH CARE CORP DBA ST JOHN'S HOME

Laboratory Demographics

CLIA Number: 33D0173383

Facility Name: ST JOHN'S HEALTH CARE CORP DBA ST JOHN'S HOME

Facility Address:
150 HIGHLAND AVE
ROCHESTER, NY
ZIP 14620
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Facility Phone Number: 585 271-1680

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1497958987

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D0173383
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	ST JOHN'S HEALTH CARE CORP DBA ST JOHN'S HOME
Street	150 HIGHLAND AVE
City	ROCHESTER
State	NY
ZIP	14620
Phone	585 271-1680
CertificateType	4
CertificateEffectiveDate	11/15/2005
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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