34D0240774 CLIA NUMBER - NORTH CAROLINA NEPHROLOGY, PA

Laboratory Demographics

CLIA Number: 34D0240774

Facility Name: NORTH CAROLINA NEPHROLOGY, PA

Facility Address:
3604 BUSH STREET
RALEIGH, NC
ZIP 27609
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Facility Phone Number: 919 459-8415

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1811404999

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name	Field Value
CLIA Number	34D0240774
LAB Type	Physician Office
Facility Name	NORTH CAROLINA NEPHROLOGY, PA
Street	3604 BUSH STREET
City	RALEIGH
State	NC
ZIP	27609
Phone	919 459-8415
CertificateType	3
CertificateEffectiveDate	6/7/2023
CertificateExpirationDate	6/6/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024