49D0678824 CLIA NUMBER - TAZEWELL LIFE CARE, LLC DBA HERITAGE HALL - TAZEWELL

Laboratory Demographics

  • CLIA Code: 49D0678824
  • Facility Name: TAZEWELL LIFE CARE, LLC DBA HERITAGE HALL - TAZEWELL
  • Facility Address: 282 BEN BOLT AVENUE
    TAZEWELL, VA
    ZIP 24651
  • Facility Phone: 276 988-2515
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KELLY ANN HARRISON
  • NPI Number: 1154813228
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0678824
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TAZEWELL LIFE CARE, LLC DBA HERITAGE HALL - TAZEWELL
Street 282 BEN BOLT AVENUE
City TAZEWELL
State VA
ZIP 24651
Phone 276 988-2515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KELLY ANN HARRISON

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