34D2002430 CLIA NUMBER - THE SHANNON GRAY REHAB & RECOVERY CENTER GREATEST GENERATION INC DBA

Laboratory Demographics

  • CLIA Code: 34D2002430
  • Facility Name: THE SHANNON GRAY REHAB & RECOVERY CENTER GREATEST GENERATION INC DBA
  • Facility Address: 2005 SHANNON GRAY COURT
    JAMESTOWN, NC
    ZIP 27282
  • Facility Phone: 336 253-6491
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RICHARD BENNETT
  • NPI Number: 1669613071
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2002430
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name THE SHANNON GRAY REHAB & RECOVERY CENTER GREATEST GENERATION INC DBA
Street 2005 SHANNON GRAY COURT
City JAMESTOWN
State NC
ZIP 27282
Phone 336 253-6491
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RICHARD BENNETT

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