34D2121343 CLIA NUMBER - AMAT GROUP HOME, LLC

Laboratory Demographics

  • CLIA Code: 34D2121343
  • Facility Name: AMAT GROUP HOME, LLC
  • Facility Address: 906 E PROSPECT AVENUE
    RAEFORD, NC
    ZIP 28376
  • Facility Phone: 910 922-9583
  • Facility Type: Other - MENTAL HEALTH GROUP HOMES
  • Facility Type: Waiver
  • Lab Director: IBILOLA A. ARIDEGBE
  • NPI Number: 1679939896
  • Taxonomy: 101YM0800X - Counselor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2121343
LAB Type Other - MENTAL HEALTH GROUP HOMES
Facility Name AMAT GROUP HOME, LLC
Street 906 E PROSPECT AVENUE
City RAEFORD
State NC
ZIP 28376
Phone 910 922-9583
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2024
Certificate Expiration Date 11/2/2026
Facility Type Other - MENTAL HEALTH GROUP HOMES
Lab Director IBILOLA A. ARIDEGBE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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