34D0861557 CLIA NUMBER - FELLOWSHIP HALL INC

Laboratory Demographics

CLIA Number: 34D0861557

Facility Name: FELLOWSHIP HALL INC

Facility Address:
5140 DUNSTAN ROAD
GREENSBORO, NC
ZIP 27415
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Facility Phone Number: 336 621-3381

Facility Type: Other - DRUG REHAB HOSPITAL

Certificate Type: Waiver

NPI Number: 1225007719

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	34D0861557
LAB Type	Other - DRUG REHAB HOSPITAL
Facility Name	FELLOWSHIP HALL INC
Street	5140 DUNSTAN ROAD
City	GREENSBORO
State	NC
ZIP	27415
Phone	336 621-3381
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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