11D0963972 CLIA NUMBER - HABERSHAM RETREAT ADULT DAY CARE

Laboratory Demographics

  • CLIA Code: 11D0963972
  • Facility Name: HABERSHAM RETREAT ADULT DAY CARE
  • Facility Address: 150 WILLINGHAM ST
    BALDWIN, GA
    ZIP 30511
  • Facility Phone: 706 776-7131
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRAD MOORE
  • NPI Number: 1306990452
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0963972
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HABERSHAM RETREAT ADULT DAY CARE
Street 150 WILLINGHAM ST
City BALDWIN
State GA
ZIP 30511
Phone 706 776-7131
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