34D2281786 CLIA NUMBER - LIFE, INC WALNUT ST GROUP HOME

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Field Name	Field Value
CLIA Number	34D2281786
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	LIFE, INC WALNUT ST GROUP HOME
Street	1011 EAST WALNUT ST
City	GOLDSBORO
State	NC
ZIP	27530
Phone	919 736-7668
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	5/11/2025
Certificate Expiration Date	5/10/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	SANDRA DUKE

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