44D1002662 CLIA NUMBER - IVY HALL NURSING HOME, INC DBA IVY HALL NURSING HOME

Laboratory Demographics

  • CLIA Code: 44D1002662
  • Facility Name: IVY HALL NURSING HOME, INC DBA IVY HALL NURSING HOME
  • Facility Address: 301 WATAUGA AVENUE
    ELIZABETHTON, TN
    ZIP 37643
  • Facility Phone: 423 542-6512
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JUDY C. DELOACH
  • NPI Number: 1851362511
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D1002662
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name IVY HALL NURSING HOME, INC DBA IVY HALL NURSING HOME
Street 301 WATAUGA AVENUE
City ELIZABETHTON
State TN
ZIP 37643
Phone 423 542-6512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JUDY C. DELOACH

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