34D2119691 CLIA NUMBER - MARSH'S RESIDENTIAL LIVING

Laboratory Demographics

CLIA Code: 34D2119691
Facility Name: MARSH'S RESIDENTIAL LIVING
Facility Address: 223 W BROWER AVE
LIBERTY, NC
ZIP 27298
Facility Phone: 336 622-0252
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: MONICA N. MARSH
NPI Number: 1942664313
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	34D2119691
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MARSH'S RESIDENTIAL LIVING
Street	223 W BROWER AVE
City	LIBERTY
State	NC
ZIP	27298
Phone	336 622-0252
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/3/2024
Certificate Expiration Date	10/2/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MONICA N. MARSH

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