34D0240903 CLIA NUMBER - BLUE RIDGE PEDIATRICS L L P

Laboratory Demographics

  • CLIA Code: 34D0240903
  • Facility Name: BLUE RIDGE PEDIATRICS L L P
  • Facility Address: 3124 BLUE RIDGE RD STE 102
    RALEIGH, NC
    ZIP 27612
  • Facility Phone: 919 782-0021
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: NICHOLAS D'AVANZO
  • NPI Number: 1942389838
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D0240903
LAB Type Physician Office
Facility Name BLUE RIDGE PEDIATRICS L L P
Street 3124 BLUE RIDGE RD STE 102
City RALEIGH
State NC
ZIP 27612
Phone 919 782-0021
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/11/2024
Certificate Expiration Date 11/10/2026
Facility Type Physician Office
Lab Director NICHOLAS D'AVANZO

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