38D0625919 CLIA NUMBER - MENNONITE HOME LABORATORY

Laboratory Demographics

CLIA Number: 38D0625919

Facility Name: MENNONITE HOME LABORATORY

Facility Address:
5353 COLUMBUS SE
ALBANY, OR
ZIP 97321
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Facility Phone Number: 541 928-7232

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1962402271

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name	Field Value
CLIA Number	38D0625919
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	MENNONITE HOME LABORATORY
Street	5353 COLUMBUS SE
City	ALBANY
State	OR
ZIP	97321
Phone	541 928-7232
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