34D2060673 CLIA NUMBER - SENIOR TOTAL LIFE CARE

Laboratory Demographics

CLIA Code: 34D2060673
Facility Name: SENIOR TOTAL LIFE CARE
Facility Address: 1875 REMOUNT ROAD
GASTONIA, NC
ZIP 28054
Facility Phone: 704 874-0602
Facility Type: Other - PACE
Facility Type: Waiver
Lab Director: CATHY KENZIG
NPI Number: 1083058598
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	34D2060673
LAB Type	Other - PACE
Facility Name	SENIOR TOTAL LIFE CARE
Street	1875 REMOUNT ROAD
City	GASTONIA
State	NC
ZIP	28054
Phone	704 874-0602
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/14/2025
Certificate Expiration Date	6/13/2027
Facility Type	Other - PACE
Lab Director	CATHY KENZIG

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