34D0931113 CLIA NUMBER - GRANITE FALLS LTC, LLC JACOB'S CREEK NURSING AND REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 34D0931113
  • Facility Name: GRANITE FALLS LTC, LLC JACOB'S CREEK NURSING AND REHABILITATION CENTER
  • Facility Address: 1721 BALD HILL LOOP
    MADISON, NC
    ZIP 27025
  • Facility Phone: 336 548-9658
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON M. KNIGHT
  • NPI Number: 1255367447
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D0931113
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRANITE FALLS LTC, LLC JACOB'S CREEK NURSING AND REHABILITATION CENTER
Street 1721 BALD HILL LOOP
City MADISON
State NC
ZIP 27025
Phone 336 548-9658
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SHANNON M. KNIGHT

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