37D0876472 CLIA NUMBER - COLONIAL MANOR NURSING HOME

Laboratory Demographics

CLIA Number: 37D0876472

Facility Name: COLONIAL MANOR NURSING HOME

Facility Address:
1815 E SKELLY DRIVE
TULSA, OK
ZIP 74105
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Facility Phone Number: 918 743-7838

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1124129556

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name	Field Value
CLIA Number	37D0876472
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	COLONIAL MANOR NURSING HOME
Street	1815 E SKELLY DRIVE
City	TULSA
State	OK
ZIP	74105
Phone	918 743-7838
CertificateType	4
CertificateEffectiveDate	9/17/2023
CertificateExpirationDate	9/16/2025
FacilityType	Waiver

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