34D2150622 CLIA NUMBER - DOVE ROAD

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Field Name	Field Value
CLIA Number	34D2150622
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	DOVE ROAD
Street	102 DOVE ROAD
City	CREEDMOOR
State	NC
ZIP	27522
Phone	919 528-2555
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/28/2024
Certificate Expiration Date	6/27/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	DORENE CHAVIS

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