34D2223830 CLIA NUMBER - LIFE, FOLLY GROUP HOME

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CLIA Record

Field Name Field Value
CLIA Number 34D2223830
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name LIFE, FOLLY GROUP HOME
Street 65 FOLLY STREET SW
City SUPPLY
State NC
ZIP 28462
Phone 910 754-2855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
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