49D2122026 CLIA NUMBER - BAY LAKE LIMITED PARTNERSHIP

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Laboratory Demographics

CLIA Number: 49D2122026

Facility Name: BAY LAKE LIMITED PARTNERSHIP

Facility Address:
4225 SHORE DRIVE
VIRGINIA BEACH, VA
ZIP 23455
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Facility Phone Number: 757 460-8868

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1053575613

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	49D2122026
LAB Type	Assisted Living Facility
Facility Name	BAY LAKE LIMITED PARTNERSHIP
Street	4225 SHORE DRIVE
City	VIRGINIA BEACH
State	VA
ZIP	23455
Phone	757 460-8868
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024