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34D0956051 CLIA NUMBER - IVY AT GASTONIA, THE

Laboratory Demographics

CLIA Number: 34D0956051

Facility Name: IVY AT GASTONIA, THE

Facility Address:
4414 WILKINSON BOULEVARD
GASTONIA, NC
ZIP 28056
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Facility Phone Number: 704 824-5550

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1992707939

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 34D0956051
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name IVY AT GASTONIA, THE
Street 4414 WILKINSON BOULEVARD
City GASTONIA
State NC
ZIP 28056
Phone 704 824-5550
CertificateType 4
CertificateEffectiveDate 9/9/2022
CertificateExpirationDate 9/8/2024
FacilityType Waiver

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