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

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Laboratory Demographics

CLIA Number: 34D2018217

Facility Name: FIRST ASSEMBLY LIVING CENTER ENTERPRISES, LLC

Facility Address:
160 WARREN C COLEMAN BLVD
CONCORD, NC
ZIP 28025
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Facility Phone Number: 704 793-4760

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1114063559

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	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
CertificateType	4
CertificateEffectiveDate	12/29/2022
CertificateExpirationDate	12/28/2024
FacilityType	Waiver

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