34D0922359 CLIA NUMBER - EDGECOMBE YOUTH DEVELOPMENT CENTER

Laboratory Demographics

  • CLIA Code: 34D0922359
  • Facility Name: EDGECOMBE YOUTH DEVELOPMENT CENTER
  • Facility Address: 78 POSITIVE WAY
    ROCKY MOUNT, NC
    ZIP 27801
  • Facility Phone: 252 544-5682
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: EBONY CRUTCHFIELD
  • NPI Number: 1598162240
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D0922359
LAB Type School/Student Health Service
Facility Name EDGECOMBE YOUTH DEVELOPMENT CENTER
Street 78 POSITIVE WAY
City ROCKY MOUNT
State NC
ZIP 27801
Phone 252 544-5682
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type School/Student Health Service
Lab Director EBONY CRUTCHFIELD

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