37D2190508 CLIA NUMBER - COUNTRY GARDENS ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 37D2190508

Facility Name: COUNTRY GARDENS ASSISTED LIVING

Facility Address:
611 S COUNTRY CLUB RD
MUSKOGEE, OK
ZIP 74403
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Facility Phone Number: 918 686-8100

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1841411972

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	37D2190508
LAB Type	Assisted Living Facility
Facility Name	COUNTRY GARDENS ASSISTED LIVING
Street	611 S COUNTRY CLUB RD
City	MUSKOGEE
State	OK
ZIP	74403
Phone	918 686-8100
CertificateType	4
CertificateEffectiveDate	8/14/2022
CertificateExpirationDate	8/13/2024
FacilityType	Waiver

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