34D0675078 CLIA NUMBER - EAGLE PEAK LTC GROUP, LLC DBA KERR LAKE NURSING AND REHAB CENTER

Laboratory Demographics

  • CLIA Code: 34D0675078
  • Facility Name: EAGLE PEAK LTC GROUP, LLC DBA KERR LAKE NURSING AND REHAB CENTER
  • Facility Address: 1245 PARK AVENUE
    HENDERSON, NC
    ZIP 27536
  • Facility Phone: 919 492-7021
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LISA JOHNSON
  • NPI Number: 1669657755
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D0675078
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EAGLE PEAK LTC GROUP, LLC DBA KERR LAKE NURSING AND REHAB CENTER
Street 1245 PARK AVENUE
City HENDERSON
State NC
ZIP 27536
Phone 919 492-7021
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 LISA JOHNSON

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