34D0931482 CLIA NUMBER - TAR RIVER LTC GROUP, LLC DBA CHOWAN RIVER NURSING AND REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 34D0931482
  • Facility Name: TAR RIVER LTC GROUP, LLC DBA CHOWAN RIVER NURSING AND REHABILITATION CENTER
  • Facility Address: 1341 PARADISE ROAD
    EDENTON, NC
    ZIP 27932
  • Facility Phone: 252 482-7481
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DIANNE NIXON
  • NPI Number: 1083659692
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D0931482
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TAR RIVER LTC GROUP, LLC DBA CHOWAN RIVER NURSING AND REHABILITATION CENTER
Street 1341 PARADISE ROAD
City EDENTON
State NC
ZIP 27932
Phone 252 482-7481
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DIANNE NIXON

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