34D2017645 CLIA NUMBER - BROOKDALE UNION

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Laboratory Demographics

CLIA Number: 34D2017645

Facility Name: BROOKDALE UNION

Facility Address:
1717 UNION RD
GASTONIA, NC
ZIP 28054
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Facility Phone Number: 704 864-9440

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1093871949

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	34D2017645
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE UNION
Street	1717 UNION RD
City	GASTONIA
State	NC
ZIP	28054
Phone	704 864-9440
CertificateType	4
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	Waiver

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