34D2305317 CLIA NUMBER - PERSON COUNTY GROUP HOMES, INC - WILLOW LANE

Laboratory Demographics

  • CLIA Code: 34D2305317
  • Facility Name: PERSON COUNTY GROUP HOMES, INC - WILLOW LANE
  • Facility Address: 380 JERRY DIXON RD
    LEASBURG, NC
    ZIP 27291
  • Facility Phone: 336 599-9421
  • Facility Type: Other - GROUP HOME
  • Facility Type: Waiver
  • Lab Director: MICHELLE D. HODGIN
  • NPI Number: 1679908420
  • Taxonomy: 253Z00000X - In Home Supportive Care

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2305317
LAB Type Other - GROUP HOME
Facility Name PERSON COUNTY GROUP HOMES, INC - WILLOW LANE
Street 380 JERRY DIXON RD
City LEASBURG
State NC
ZIP 27291
Phone 336 599-9421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Other - GROUP HOME
Lab Director MICHELLE D. HODGIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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