34D0677975 CLIA NUMBER - PELICAN HEALTH AT CHARLOTTE

Laboratory Demographics

CLIA Number: 34D0677975

Facility Name: PELICAN HEALTH AT CHARLOTTE

Facility Address:
2616 EAST FIFTH STREET
CHARLOTTE, NC
ZIP 28204
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Facility Phone Number: 704 333-5165

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1114480233

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	34D0677975
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PELICAN HEALTH AT CHARLOTTE
Street	2616 EAST FIFTH STREET
City	CHARLOTTE
State	NC
ZIP	28204
Phone	704 333-5165
CertificateType	4
CertificateEffectiveDate	6/18/2023
CertificateExpirationDate	6/17/2025
FacilityType	Waiver

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