44D0935514 CLIA NUMBER - LAKEBRIDGE A WATER'S COMMUNITY, LLC

Laboratory Demographics

  • CLIA Code: 44D0935514
  • Facility Name: LAKEBRIDGE A WATER'S COMMUNITY, LLC
  • Facility Address: 115 WOODLAWN DRIVE
    JOHNSON CITY, TN
    ZIP 37604
  • Facility Phone: 423 975-0095
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: AUSTIN STACY
  • NPI Number: 1043763592
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 44D0935514
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LAKEBRIDGE A WATER'S COMMUNITY, LLC
Street 115 WOODLAWN DRIVE
City JOHNSON CITY
State TN
ZIP 37604
Phone 423 975-0095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director AUSTIN STACY

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