34D1089262 CLIA NUMBER - LEGACY HEIGHTS

Laboratory Demographics

  • CLIA Code: 34D1089262
  • Facility Name: LEGACY HEIGHTS
  • Facility Address: 11230 BALLANTYNE TRACE COURT
    CHARLOTTE, NC
    ZIP 28277
  • Facility Phone: 704 544-7220
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER PAULINE
  • NPI Number: 1194877001
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D1089262
LAB Type Assisted Living Facility
Facility Name LEGACY HEIGHTS
Street 11230 BALLANTYNE TRACE COURT
City CHARLOTTE
State NC
ZIP 28277
Phone 704 544-7220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Assisted Living Facility
Lab Director CHRISTOPHER PAULINE

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