34D2019439 CLIA NUMBER - EDENTON HOUSE

Laboratory Demographics

  • CLIA Code: 34D2019439
  • Facility Name: EDENTON HOUSE
  • Facility Address: 323 MEDICAL ARTS DRIVE
    EDENTON, NC
    ZIP 27932
  • Facility Phone: (252) 482-1113
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RANDY GRIFFIN
  • NPI Number: 1760682579
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2019439
LAB Type Assisted Living Facility
Facility Name EDENTON HOUSE
Street 323 MEDICAL ARTS DRIVE
City EDENTON
State NC
ZIP 27932
Phone 2524821113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Assisted Living Facility
Lab Director RANDY GRIFFIN

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This page was last updated on: 5/18/2026