34D2239621 CLIA NUMBER - MT AIRY ACTT

Laboratory Demographics

  • CLIA Code: 34D2239621
  • Facility Name: MT AIRY ACTT
  • Facility Address: 414 WEST LEBANAON STREET
    MT AIRY, NC
    ZIP 27030
  • Facility Phone: 336 443-0833
  • Facility Type: Other - ASSERTIVE COMM TREATMENT
  • Facility Type: Waiver
  • Lab Director: MICHELLE KING STAMPS
  • NPI Number: 1033885801
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2239621
LAB Type Other - ASSERTIVE COMM TREATMENT
Facility Name MT AIRY ACTT
Street 414 WEST LEBANAON STREET
City MT AIRY
State NC
ZIP 27030
Phone 336 443-0833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Other - ASSERTIVE COMM TREATMENT
Lab Director MICHELLE KING STAMPS

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