34D2143677 CLIA NUMBER - EAGLE HOME 3

Laboratory Demographics

  • CLIA Code: 34D2143677
  • Facility Name: EAGLE HOME 3
  • Facility Address: 1500 GARNER RD, STE A
    RALEIGH, NC
    ZIP 27610
  • Facility Phone: 919 872-7686
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: NWANKWO N. ROSEMARY
  • NPI Number: 1043525017
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2143677
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name EAGLE HOME 3
Street 1500 GARNER RD, STE A
City RALEIGH
State NC
ZIP 27610
Phone 919 872-7686
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director NWANKWO N. ROSEMARY

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