34D0237868 CLIA NUMBER - GLEN RAVEN MEDICAL CARE CENTER

Laboratory Demographics

  • CLIA Code: 34D0237868
  • Facility Name: GLEN RAVEN MEDICAL CARE CENTER
  • Facility Address: 1611 FLORA AVENUE ATTN MELONY WADE, OFFICE MANAGER
    BURLINGTON, NC
    ZIP 27217
  • Facility Phone: 336 270-5622
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAVED MASOUD
  • NPI Number: 1972949949
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0237868
LAB Type Physician Office
Facility Name GLEN RAVEN MEDICAL CARE CENTER
Street 1611 FLORA AVENUE ATTN MELONY WADE, OFFICE MANAGER
City BURLINGTON
State NC
ZIP 27217
Phone 336 270-5622
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Physician Office
Lab Director JAVED MASOUD

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