11D0880866 CLIA NUMBER - HEARDMONT NURSING HOME

Laboratory Demographics

  • CLIA Code: 11D0880866
  • Facility Name: HEARDMONT NURSING HOME
  • Facility Address: 1043 LONGSTREET ROAD
    ELBERTON, GA
    ZIP 30635
  • Facility Phone: (706) 283-5429
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Microscopy
  • Lab Director: BROOKE JOHNSON
  • NPI Number: 1841262912
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0880866
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HEARDMONT NURSING HOME
Street 1043 LONGSTREET ROAD
City ELBERTON
State GA
ZIP 30635
Phone 7062835429
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/27/2025
Certificate Expiration Date 12/26/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BROOKE JOHNSON

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This page was last updated on: 5/18/2026