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34D2068863 CLIA NUMBER - RAINBOW 66 STOREHOUSE

Laboratory Demographics

CLIA Number: 34D2068863

Facility Name: RAINBOW 66 STOREHOUSE

Facility Address:
525 ATKINSON STREET
LAURINBURG, NC
ZIP 28352
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Facility Phone Number: 910 276-0766

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver
NPI Number: 1376625814

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 34D2068863
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name RAINBOW 66 STOREHOUSE
Street 525 ATKINSON STREET
City LAURINBURG
State NC
ZIP 28352
Phone 910 276-0766
CertificateType 4
CertificateEffectiveDate 11/13/2023
CertificateExpirationDate 11/12/2025
FacilityType Waiver

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