34D2133137 CLIA NUMBER - LINDA SHORTS HOME

Laboratory Demographics

CLIA Number: 34D2133137

Facility Name: LINDA SHORTS HOME

Facility Address:
106 GRANTHAM LANE
JACKSONVILLE, NC
ZIP 28546
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Facility Phone Number: 910 455-6724

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1316003668

Taxonomy: 261QD1600X - Clinic/Center
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

CLIA Record

Field Name	Field Value
CLIA Number	34D2133137
LAB Type	Assisted Living Facility
Facility Name	LINDA SHORTS HOME
Street	106 GRANTHAM LANE
City	JACKSONVILLE
State	NC
ZIP	28546
Phone	910 455-6724
CertificateType	4
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Waiver

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