11D0963971 CLIA NUMBER - HABERSHAM RETREAT ASSISTED LIVING #2

Laboratory Demographics

  • CLIA Code: 11D0963971
  • Facility Name: HABERSHAM RETREAT ASSISTED LIVING #2
  • Facility Address: 212 STONECYPHER ST
    CORNELIA, GA
    ZIP 30531
  • Facility Phone: 706 754-4564
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRAD MOORE
  • NPI Number: 1093993735
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 11D0963971
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HABERSHAM RETREAT ASSISTED LIVING #2
Street 212 STONECYPHER ST
City CORNELIA
State GA
ZIP 30531
Phone 706 754-4564
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BRAD MOORE

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This page was last updated on: 9/29/2025