37D2193299 CLIA NUMBER - HENRYETTA COMMUNITY SKILLED HEALTHCARE & REHAB

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Laboratory Demographics

CLIA Number: 37D2193299

Facility Name: HENRYETTA COMMUNITY SKILLED HEALTHCARE & REHAB

Facility Address:
212 N ANTES ATTN KIM SLYCONISH
HENRYETTA, OK
ZIP 74437
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Facility Phone Number: 918 652-8797

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1174587976

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name	Field Value
CLIA Number	37D2193299
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	HENRYETTA COMMUNITY SKILLED HEALTHCARE & REHAB
Street	212 N ANTES ATTN KIM SLYCONISH
City	HENRYETTA
State	OK
ZIP	74437
Phone	918 652-8797
CertificateType	4
CertificateEffectiveDate	9/18/2022
CertificateExpirationDate	9/17/2024
FacilityType	Waiver

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