34D2075053 CLIA NUMBER - BLACKWELLS COMMUNITY LIVING

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Laboratory Demographics

CLIA Number: 34D2075053

Facility Name: BLACKWELLS COMMUNITY LIVING

Facility Address:
509 FERNWAY DR
BURLINGTON, NC
ZIP 27217
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Facility Phone Number: 336 270-4463

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1598068900

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	34D2075053
LAB Type	Assisted Living Facility
Facility Name	BLACKWELLS COMMUNITY LIVING
Street	509 FERNWAY DR
City	BURLINGTON
State	NC
ZIP	27217
Phone	336 270-4463
CertificateType	4
CertificateEffectiveDate	7/18/2023
CertificateExpirationDate	7/17/2025
FacilityType	Waiver

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