34D2016267 CLIA NUMBER - FOREST PARK

Laboratory Demographics

  • CLIA Code: 34D2016267
  • Facility Name: FOREST PARK
  • Facility Address: 2910 FOREST PARK DRIVE
    RANDLEMAN, NC
    ZIP 27317
  • Facility Phone: 336 495-6780
  • Facility Type: Other - GROUP HOME
  • Facility Type: Waiver
  • Lab Director: STACY MASSEY
  • NPI Number: 1497786982
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2016267
LAB Type Other - GROUP HOME
Facility Name FOREST PARK
Street 2910 FOREST PARK DRIVE
City RANDLEMAN
State NC
ZIP 27317
Phone 336 495-6780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Other - GROUP HOME
Lab Director STACY MASSEY

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