34D2068863 CLIA NUMBER - RAINBOW 66 STOREHOUSE

Laboratory Demographics

  • CLIA Code: 34D2068863
  • Facility Name: RAINBOW 66 STOREHOUSE
  • Facility Address: 525 ATKINSON STREET
    LAURINBURG, NC
    ZIP 28352
  • Facility Phone: 910 276-0766
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: KIMMIE JOHNSON
  • NPI Number: 1376625814
  • Taxonomy: 251E00000X - Home Health

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KIMMIE JOHNSON

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