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38D0625330 CLIA NUMBER - SAPPHIRE AT GRACELEN TERRACE

Laboratory Demographics

CLIA Number: 38D0625330

Facility Name: SAPPHIRE AT GRACELEN TERRACE

Facility Address:
10948 SE BOISE ST
PORTLAND, OR
ZIP 97266
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Facility Phone Number: 503 760-1727

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1023313491

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 38D0625330
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SAPPHIRE AT GRACELEN TERRACE
Street 10948 SE BOISE ST
City PORTLAND
State OR
ZIP 97266
Phone 503 760-1727
CertificateType 4
CertificateEffectiveDate 1/1/2024
CertificateExpirationDate 12/31/2025
FacilityType Waiver

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