34D2016066 CLIA NUMBER - GREEN LEAF CARE CENTER

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Laboratory Demographics

CLIA Number: 34D2016066

Facility Name: GREEN LEAF CARE CENTER

Facility Address:
2041 NC 210 N
LILLINGTON, NC
ZIP 27546
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Facility Phone Number: 910 893-8181

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1265785463

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	34D2016066
LAB Type	Assisted Living Facility
Facility Name	GREEN LEAF CARE CENTER
Street	2041 NC 210 N
City	LILLINGTON
State	NC
ZIP	27546
Phone	910 893-8181
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

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