35D0655648 CLIA NUMBER - GOOD SAMARITAN SOCIETY - PARK RIVER

Laboratory Demographics

CLIA Number: 35D0655648

Facility Name: GOOD SAMARITAN SOCIETY - PARK RIVER

Facility Address:
301 COUNTY ROAD 12-B
PARK RIVER, ND
ZIP 58270
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Facility Phone Number: 701 284-7115

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1740769595

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	35D0655648
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	GOOD SAMARITAN SOCIETY - PARK RIVER
Street	301 COUNTY ROAD 12-B
City	PARK RIVER
State	ND
ZIP	58270
Phone	701 284-7115
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