34D2221855 CLIA NUMBER - GRACE VILLAGE ASSISTED LIVING & MEMORY CARE

Laboratory Demographics

  • CLIA Code: 34D2221855
  • Facility Name: GRACE VILLAGE ASSISTED LIVING & MEMORY CARE
  • Facility Address: 501 RIVER BEND DR
    GRANITE FALLS, NC
    ZIP 28630
  • Facility Phone: 828 212-5121
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LYN W. MIKEAL
  • NPI Number: 1710528377
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2221855
LAB Type Assisted Living Facility
Facility Name GRACE VILLAGE ASSISTED LIVING & MEMORY CARE
Street 501 RIVER BEND DR
City GRANITE FALLS
State NC
ZIP 28630
Phone 828 212-5121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Assisted Living Facility
Lab Director LYN W. MIKEAL

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