34D2213354 CLIA NUMBER - BROOKDALE WAKE FOREST

Laboratory Demographics

  • CLIA Code: 34D2213354
  • Facility Name: BROOKDALE WAKE FOREST
  • Facility Address: 611 S BROOK ST
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 562-8400
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHARISSE M. FAIN
  • NPI Number: 1699831594
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2213354
LAB Type Assisted Living Facility
Facility Name BROOKDALE WAKE FOREST
Street 611 S BROOK ST
City WAKE FOREST
State NC
ZIP 27587
Phone 919 562-8400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Assisted Living Facility
Lab Director CHARISSE M. FAIN

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