36D1086388 CLIA NUMBER - OTTERBEIN CLEARCREEK LLC

Laboratory Demographics

CLIA Number: 36D1086388

Facility Name: OTTERBEIN CLEARCREEK LLC

Facility Address:
9320 AVALON CIRCLE
CENTERVILLE, OH
ZIP 45458
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Facility Phone Number: 937 885-5426

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1992977516

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	36D1086388
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	OTTERBEIN CLEARCREEK LLC
Street	9320 AVALON CIRCLE
City	CENTERVILLE
State	OH
ZIP	45458
Phone	937 885-5426
CertificateType	4
CertificateEffectiveDate	7/11/2022
CertificateExpirationDate	7/10/2024
FacilityType	Waiver

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