34D0245895 CLIA NUMBER - CORNELIA NIXON DAVIS HEALTH CARE CTR

Laboratory Demographics

  • CLIA Code: 34D0245895
  • Facility Name: CORNELIA NIXON DAVIS HEALTH CARE CTR
  • Facility Address: 1011 PORTERS NECK RD ATTN LEILANI CAPONE
    WILMINGTON, NC
    ZIP 28411
  • Facility Phone: 910 686-7195
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHARLES LONG
  • NPI Number: 1063703866
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 34D0245895
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CORNELIA NIXON DAVIS HEALTH CARE CTR
Street 1011 PORTERS NECK RD ATTN LEILANI CAPONE
City WILMINGTON
State NC
ZIP 28411
Phone 910 686-7195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHARLES LONG

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