34D1074407 CLIA NUMBER - RHA HEALTH SERVICES, LLC - BEAR CREEK

Laboratory Demographics

CLIA Number: 34D1074407

Facility Name: RHA HEALTH SERVICES, LLC - BEAR CREEK

Facility Address:
5840 GREENWOOD AVENUE
LA GRANGE, NC
ZIP 28551
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Facility Phone Number: 252 566-9181

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1043379340

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	34D1074407
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	RHA HEALTH SERVICES, LLC - BEAR CREEK
Street	5840 GREENWOOD AVENUE
City	LA GRANGE
State	NC
ZIP	28551
Phone	252 566-9181
CertificateType	4
CertificateEffectiveDate	9/27/2023
CertificateExpirationDate	9/26/2025
FacilityType	Waiver

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