34D2156772 CLIA NUMBER - LIFE INC / EDGEWOOD GROUP HOME

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CLIA Record

Field Name Field Value
CLIA Number 34D2156772
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name LIFE INC / EDGEWOOD GROUP HOME
Street 77 EDGEWOOD DRIVE
City CHOCOWINITY
State NC
ZIP 27817
Phone 252 974-2600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director KIM MCINTYRE

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