34D1075627 CLIA NUMBER - ELDERHAUS INC

Laboratory Demographics

CLIA Code: 34D1075627
Facility Name: ELDERHAUS INC
Facility Address: 1320 N COLLEGE ROAD
WILMINGTON, NC
ZIP 28405
Facility Phone: 910 343-8209
Facility Type: Physician Office
Facility Type: Waiver
Lab Director: DAVID RODDY
NPI Number: 1699983312
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	34D1075627
LAB Type	Physician Office
Facility Name	ELDERHAUS INC
Street	1320 N COLLEGE ROAD
City	WILMINGTON
State	NC
ZIP	28405
Phone	910 343-8209
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/24/2023
Certificate Expiration Date	10/23/2025
Facility Type	Physician Office
Lab Director	DAVID RODDY

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