34D2313567 CLIA NUMBER - PROLIFIC COMMUNITY RESOURCES/DBA MORAVIAN ENTERPRISES

Laboratory Demographics

CLIA Code: 34D2313567
Facility Name: PROLIFIC COMMUNITY RESOURCES/DBA MORAVIAN ENTERPRISES
Facility Address: 2515-A PHILLIPS AVE
GREENSBORO, NC
ZIP 27405
Facility Phone: 336 542-0581
Facility Type: Other - GROUP HOME
Facility Type: Waiver
Lab Director: JAMIL MORAVIAN
NPI Number: 1710489976
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	34D2313567
LAB Type	Other - GROUP HOME
Facility Name	PROLIFIC COMMUNITY RESOURCES/DBA MORAVIAN ENTERPRISES
Street	2515-A PHILLIPS AVE
City	GREENSBORO
State	NC
ZIP	27405
Phone	336 542-0581
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/4/2024
Certificate Expiration Date	11/3/2026
Facility Type	Other - GROUP HOME
Lab Director	JAMIL MORAVIAN

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