34D2197972 CLIA NUMBER - RHA HEALTH SERVICES LLC - CAPTAIN WATCH

Laboratory Demographics

  • CLIA Code: 34D2197972
  • Facility Name: RHA HEALTH SERVICES LLC - CAPTAIN WATCH
  • Facility Address: 514 TODD DRIVE
    CONCORD, NC
    ZIP 28025
  • Facility Phone: 704 925-8041
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: KATHERICE BENTON
  • NPI Number: 1215062575
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 34D2197972
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name RHA HEALTH SERVICES LLC - CAPTAIN WATCH
Street 514 TODD DRIVE
City CONCORD
State NC
ZIP 28025
Phone 704 925-8041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KATHERICE BENTON

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