34D2064900 CLIA NUMBER - PINE FORREST HOME FOR THE AGED

Laboratory Demographics

  • CLIA Code: 34D2064900
  • Facility Name: PINE FORREST HOME FOR THE AGED
  • Facility Address: 312 BROAD STREET
    REIDSVILLE, NC
    ZIP 27320
  • Facility Phone: (336) 342-1311
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TRUDY J. BLACKWELL
  • NPI Number: 1720145113
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2064900
LAB Type Assisted Living Facility
Facility Name PINE FORREST HOME FOR THE AGED
Street 312 BROAD STREET
City REIDSVILLE
State NC
ZIP 27320
Phone 3363421311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Assisted Living Facility
Lab Director TRUDY J. BLACKWELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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