34D2021505 CLIA NUMBER - BROOKDALE PEACHTREE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 34D2021505
  • Facility Name: BROOKDALE PEACHTREE ASSISTED LIVING
  • Facility Address: 2806 PEACHTREE ROAD
    STATESVILLE, NC
    ZIP 28625
  • Facility Phone: 704 872-1946
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: HEATHER MELTON
  • NPI Number: 1417013822
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2021505
LAB Type Assisted Living Facility
Facility Name BROOKDALE PEACHTREE ASSISTED LIVING
Street 2806 PEACHTREE ROAD
City STATESVILLE
State NC
ZIP 28625
Phone 704 872-1946
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Assisted Living Facility
Lab Director HEATHER MELTON

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