34D0703553 CLIA NUMBER - ROY O FAGAN III MD

Laboratory Demographics

  • CLIA Code: 34D0703553
  • Facility Name: ROY O FAGAN III MD
  • Facility Address: 419 W HARRISON STREET
    REIDSVILLE, NC
    ZIP 27320
  • Facility Phone: 910 342-4448
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROY O. FAGAN I I I, MD
  • NPI Number: 1023075140
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0703553
LAB Type Physician Office
Facility Name ROY O FAGAN III MD
Street 419 W HARRISON STREET
City REIDSVILLE
State NC
ZIP 27320
Phone 910 342-4448
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ROY O. FAGAN I I I, MD

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