34D2316885 CLIA NUMBER - ILLUMINATE NORTH CAROLINA

Laboratory Demographics

  • CLIA Code: 34D2316885
  • Facility Name: ILLUMINATE NORTH CAROLINA
  • Facility Address: 510 DABNEY DRIVE SUITE C
    HENDERSON, NC
    ZIP 27536
  • Facility Phone: 919 622-5532
  • Facility Type: Other - SUBSTANCE ABUSE INTENSIVE
  • Facility Type: Waiver
  • Lab Director: LINDSEY M. HUMPHREYS
  • NPI Number: 1821844796
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 34D2316885
LAB Type Other - SUBSTANCE ABUSE INTENSIVE
Facility Name ILLUMINATE NORTH CAROLINA
Street 510 DABNEY DRIVE SUITE C
City HENDERSON
State NC
ZIP 27536
Phone 919 622-5532
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Other - SUBSTANCE ABUSE INTENSIVE
Lab Director LINDSEY M. HUMPHREYS

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