34D2195630 CLIA NUMBER - LEGACY MEMORY CARE AT KINSTON, LLC

Laboratory Demographics

  • CLIA Code: 34D2195630
  • Facility Name: LEGACY MEMORY CARE AT KINSTON, LLC
  • Facility Address: 1406 EAST SHINE STREET
    KINSTON, NC
    ZIP 28501
  • Facility Phone: 252 527-0438
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LATEEFAH IRVINE
  • NPI Number: 1760085542
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2195630
LAB Type Assisted Living Facility
Facility Name LEGACY MEMORY CARE AT KINSTON, LLC
Street 1406 EAST SHINE STREET
City KINSTON
State NC
ZIP 28501
Phone 252 527-0438
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Assisted Living Facility
Lab Director LATEEFAH IRVINE

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