34D2030930 CLIA NUMBER - RENULIFE EXTENDED

Laboratory Demographics

  • CLIA Code: 34D2030930
  • Facility Name: RENULIFE EXTENDED
  • Facility Address: 501 FOREST HILL DRIVE
    GOLDSBORO, NC
    ZIP 27534
  • Facility Phone: 919 734-0266
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CARI L. HARRISON CRUSE
  • NPI Number: 1407055858
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2030930
LAB Type Assisted Living Facility
Facility Name RENULIFE EXTENDED
Street 501 FOREST HILL DRIVE
City GOLDSBORO
State NC
ZIP 27534
Phone 919 734-0266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Assisted Living Facility
Lab Director CARI L. HARRISON CRUSE

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