34D2115326 CLIA NUMBER - COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J

Laboratory Demographics

  • CLIA Code: 34D2115326
  • Facility Name: COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J
  • Facility Address: 211 GREENBRIAR DRIVE
    JACKSONVILLE, NC
    ZIP 28546
  • Facility Phone: 910 938-9550
  • Facility Type: Other - GROUP HOME
  • Facility Type: Waiver
  • Lab Director: CAROL R. WILSON
  • NPI Number: 1780792705
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 34D2115326
LAB Type Other - GROUP HOME
Facility Name COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J
Street 211 GREENBRIAR DRIVE
City JACKSONVILLE
State NC
ZIP 28546
Phone 910 938-9550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Other - GROUP HOME
Lab Director CAROL R. WILSON

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