34D2019403 CLIA NUMBER - COUNTRY TIME INN

Laboratory Demographics

  • CLIA Code: 34D2019403
  • Facility Name: COUNTRY TIME INN
  • Facility Address: 602 BREVARD ROAD
    KINGS MOUNTAIN, NC
    ZIP 28086
  • Facility Phone: 704 739-2760
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: REHANA MAJEED
  • NPI Number: 1538155643
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2019403
LAB Type Assisted Living Facility
Facility Name COUNTRY TIME INN
Street 602 BREVARD ROAD
City KINGS MOUNTAIN
State NC
ZIP 28086
Phone 704 739-2760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Assisted Living Facility
Lab Director REHANA MAJEED

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