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45D2099521 CLIA NUMBER - MEMORIAL MEDICAL CLINIC LABORATORY

Laboratory Demographics

CLIA Number: 45D2099521

Facility Name: MEMORIAL MEDICAL CLINIC LABORATORY

Facility Address:
1016 N VIRGINIA STREET
PORT LAVACA, TX
ZIP 77979
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Facility Phone Number: 361 552-0284

Facility Type: Rural Health Clinic

Certificate Type: Certificate of Compliance
NPI Number: 1497143259

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 45D2099521
LAB Type Rural Health Clinic
Facility Name MEMORIAL MEDICAL CLINIC LABORATORY
Street 1016 N VIRGINIA STREET
City PORT LAVACA
State TX
ZIP 77979
Phone 361 552-0284
CertificateType 2
CertificateEffectiveDate 8/11/2022
CertificateExpirationDate 8/10/2024
FacilityType Compliance

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