42D2255883 CLIA NUMBER - RUBY DONALD RESIDENTIAL CARE

Laboratory Demographics

  • CLIA Code: 42D2255883
  • Facility Name: RUBY DONALD RESIDENTIAL CARE
  • Facility Address: 2 RUBY DONALD PLACE, BUILDING 4
    GREENVILLE, SC
    ZIP 29617
  • Facility Phone: 864 977-0834
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JACKIE MILLER
  • NPI Number: 1427659960
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 42D2255883
LAB Type Assisted Living Facility
Facility Name RUBY DONALD RESIDENTIAL CARE
Street 2 RUBY DONALD PLACE, BUILDING 4
City GREENVILLE
State SC
ZIP 29617
Phone 864 977-0834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Assisted Living Facility
Lab Director JACKIE MILLER

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