46D0525236 CLIA NUMBER - WIDE HORIZONS INTERMEDIATE CARE FACILITY

Laboratory Demographics

CLIA Number: 46D0525236

Facility Name: WIDE HORIZONS INTERMEDIATE CARE FACILITY

Facility Address:
910 MONROE BLVD
OGDEN, UT
ZIP 84404
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Facility Phone Number: 801 399-5876

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1710419114

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	46D0525236
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	WIDE HORIZONS INTERMEDIATE CARE FACILITY
Street	910 MONROE BLVD
City	OGDEN
State	UT
ZIP	84404
Phone	801 399-5876
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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