34D2064901 CLIA NUMBER - AUTUMN VILLAGE ASSISTED LIVING AFFINITY LIVING GROUP

Laboratory Demographics

  • CLIA Code: 34D2064901
  • Facility Name: AUTUMN VILLAGE ASSISTED LIVING AFFINITY LIVING GROUP
  • Facility Address: 235 NORTH NC HIGHWAY 41
    BEULAVILLE, NC
    ZIP 28518
  • Facility Phone: 910 298-5877
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TAMARA J. HERRING
  • NPI Number: 1992929475
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2064901
LAB Type Assisted Living Facility
Facility Name AUTUMN VILLAGE ASSISTED LIVING AFFINITY LIVING GROUP
Street 235 NORTH NC HIGHWAY 41
City BEULAVILLE
State NC
ZIP 28518
Phone 910 298-5877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Assisted Living Facility
Lab Director TAMARA J. HERRING

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