34D0886940 CLIA NUMBER - TAMMY LYNN CENTER, INC

Laboratory Demographics

CLIA Number: 34D0886940

Facility Name: TAMMY LYNN CENTER, INC

Facility Address:
739 CHAPPELL DRIVE
RALEIGH, NC
ZIP 27606
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Facility Phone Number: 919 832-3909

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1700936770

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	34D0886940
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	TAMMY LYNN CENTER, INC
Street	739 CHAPPELL DRIVE
City	RALEIGH
State	NC
ZIP	27606
Phone	919 832-3909
CertificateType	4
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	Waiver

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