34D0951140 CLIA NUMBER - PRODIGY TRANSITIONAL REHAB

Laboratory Demographics

  • CLIA Code: 34D0951140
  • Facility Name: PRODIGY TRANSITIONAL REHAB
  • Facility Address: 911 WESTERN BOULEVARD
    TARBORO, NC
    ZIP 27886
  • Facility Phone: (252) 823-2041
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIE BAKER
  • NPI Number: 1720166838
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D0951140
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRODIGY TRANSITIONAL REHAB
Street 911 WESTERN BOULEVARD
City TARBORO
State NC
ZIP 27886
Phone 2528232041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIE BAKER

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This page was last updated on: 5/18/2026