34D2018217 CLIA NUMBER - FIRST ASSEMBLY LIVING CENTER ENTERPRISES, LLC

Laboratory Demographics

  • CLIA Code: 34D2018217
  • Facility Name: FIRST ASSEMBLY LIVING CENTER ENTERPRISES, LLC
  • Facility Address: 160 WARREN C COLEMAN BLVD
    CONCORD, NC
    ZIP 28025
  • Facility Phone: 704 793-4760
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: STEPHANIE RICKARD
  • NPI Number: 1114063559
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2018217
LAB Type Assisted Living Facility
Facility Name FIRST ASSEMBLY LIVING CENTER ENTERPRISES, LLC
Street 160 WARREN C COLEMAN BLVD
City CONCORD
State NC
ZIP 28025
Phone 704 793-4760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Assisted Living Facility
Lab Director STEPHANIE RICKARD

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This page was last updated on: 6/4/2025