34D2044643 CLIA NUMBER - KRYSTAL'S HOUSE

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Laboratory Demographics

CLIA Number: 34D2044643

Facility Name: KRYSTAL'S HOUSE

Facility Address:
83 WHITE HORSE ROAD
PIKEVILLE, NC
ZIP 27863
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Facility Phone Number: 252 747-2909

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1336271691

Taxonomy: 311ZA0620X - Custodial Care Facility
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

CLIA Record

Field Name	Field Value
CLIA Number	34D2044643
LAB Type	Assisted Living Facility
Facility Name	KRYSTAL'S HOUSE
Street	83 WHITE HORSE ROAD
City	PIKEVILLE
State	NC
ZIP	27863
Phone	252 747-2909
CertificateType	4
CertificateEffectiveDate	7/27/2022
CertificateExpirationDate	7/26/2024
FacilityType	Waiver

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