38D0627086 CLIA NUMBER - COAST FORK NURSING CENTER LABORATORY

Laboratory Demographics

CLIA Number: 38D0627086

Facility Name: COAST FORK NURSING CENTER LABORATORY

Facility Address:
515 GRANT ST
COTTAGE GROVE, OR
ZIP 97424
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Facility Phone Number: 541 942-5528

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1407842800

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	38D0627086
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	COAST FORK NURSING CENTER LABORATORY
Street	515 GRANT ST
City	COTTAGE GROVE
State	OR
ZIP	97424
Phone	541 942-5528
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