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52D0673255 CLIA NUMBER - CHRISTIAN HOME AND REHABILITATION CENTER

Laboratory Demographics

CLIA Number: 52D0673255

Facility Name: CHRISTIAN HOME AND REHABILITATION CENTER

Facility Address:
452 FOX LAKE ROAD
WAUPUN, WI
ZIP 53963
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Facility Phone Number: 920 324-9051

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1457312209

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 52D0673255
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CHRISTIAN HOME AND REHABILITATION CENTER
Street 452 FOX LAKE ROAD
City WAUPUN
State WI
ZIP 53963
Phone 920 324-9051
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