11D2197427 CLIA NUMBER - HABERSHAM HOME

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Laboratory Demographics

CLIA Number: 11D2197427

Facility Name: HABERSHAM HOME

Facility Address:
541 HISTORIC HIGHWAY 441 N
DEMOREST, GA
ZIP 30535
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Facility Phone Number: 706 754-3113

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1538291703

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	11D2197427
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	HABERSHAM HOME
Street	541 HISTORIC HIGHWAY 441 N
City	DEMOREST
State	GA
ZIP	30535
Phone	706 754-3113
CertificateType	4
CertificateEffectiveDate	10/25/2022
CertificateExpirationDate	10/24/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024