11D0893925 CLIA NUMBER - ROBERTA OPERATOR LLC DBA ROBERTA HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 11D0893925
  • Facility Name: ROBERTA OPERATOR LLC DBA ROBERTA HEALTHCARE CENTER
  • Facility Address: 420 MYRTLE DRIVE
    ROBERTA, GA
    ZIP 31078
  • Facility Phone: (478) 836-3101
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ELISA WILLIS
  • NPI Number: 1083776520
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0893925
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ROBERTA OPERATOR LLC DBA ROBERTA HEALTHCARE CENTER
Street 420 MYRTLE DRIVE
City ROBERTA
State GA
ZIP 31078
Phone 4788363101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ELISA WILLIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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