34D2133092 CLIA NUMBER - GREEN HILL RECOVERY, LLC

Laboratory Demographics

CLIA Number: 34D2133092

Facility Name: GREEN HILL RECOVERY, LLC

Facility Address:
6124 SAINT GILES ST
RALEIGH, NC
ZIP 27612
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Facility Phone Number: 984 204-1106

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235663790

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2133092
LAB Type	Physician Office
Facility Name	GREEN HILL RECOVERY, LLC
Street	6124 SAINT GILES ST
City	RALEIGH
State	NC
ZIP	27612
Phone	984 204-1106
CertificateType	4
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Waiver

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