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39D0879550 CLIA NUMBER - GEORGE JUNIOR REPUBLIC INFIRMARY

Laboratory Demographics

CLIA Number: 39D0879550

Facility Name: GEORGE JUNIOR REPUBLIC INFIRMARY

Facility Address:
233 GEORGE JUNIOR RD
GROVE CITY, PA
ZIP 16127
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Facility Phone Number: 724 458-9330

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1831550409

Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name Field Value
CLIA Number 39D0879550
LAB Type School/Student Health Service
Facility Name GEORGE JUNIOR REPUBLIC INFIRMARY
Street 233 GEORGE JUNIOR RD
City GROVE CITY
State PA
ZIP 16127
Phone 724 458-9330
CertificateType 4
CertificateEffectiveDate 11/22/2023
CertificateExpirationDate 11/21/2025
FacilityType Waiver

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