34D2145892 CLIA NUMBER - EVAN'S HOME

Laboratory Demographics

  • CLIA Code: 34D2145892
  • Facility Name: EVAN'S HOME
  • Facility Address: 1200 OLD FIRE TOWER ROAD
    WINTERVILLE, NC
    ZIP 28590
  • Facility Phone: 252 883-8329
  • Facility Type: Other - IDD GROUP HOME
  • Facility Type: Waiver
  • Lab Director: ADDIE H. CRAMON
  • NPI Number: 1235281692
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 34D2145892
LAB Type Other - IDD GROUP HOME
Facility Name EVAN'S HOME
Street 1200 OLD FIRE TOWER ROAD
City WINTERVILLE
State NC
ZIP 28590
Phone 252 883-8329
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Other - IDD GROUP HOME
Lab Director ADDIE H. CRAMON

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