34D2149405 CLIA NUMBER - MALLARD RIDGE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 34D2149405
  • Facility Name: MALLARD RIDGE ASSISTED LIVING
  • Facility Address: 9420 N NC HIGHWAY 150
    CLEMMONS, NC
    ZIP 27012
  • Facility Phone: 336 775-2205
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AMANDA-KAY EDWARDS
  • NPI Number: 1861523896
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2149405
LAB Type Assisted Living Facility
Facility Name MALLARD RIDGE ASSISTED LIVING
Street 9420 N NC HIGHWAY 150
City CLEMMONS
State NC
ZIP 27012
Phone 336 775-2205
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Assisted Living Facility
Lab Director AMANDA-KAY EDWARDS

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