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37D1028756 CLIA NUMBER - HERITAGE MANOR

Laboratory Demographics

CLIA Number: 37D1028756

Facility Name: HERITAGE MANOR

Facility Address:
3804 N BARR
OKLAHOMA CITY, OK
ZIP 73122
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Facility Phone Number: 405 789-7103

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1457397325

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 37D1028756
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE MANOR
Street 3804 N BARR
City OKLAHOMA CITY
State OK
ZIP 73122
Phone 405 789-7103
CertificateType 4
CertificateEffectiveDate 8/2/2022
CertificateExpirationDate 8/1/2024
FacilityType Waiver

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