34D0877495 CLIA NUMBER - POWELL'S MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 34D0877495
  • Facility Name: POWELL'S MEDICAL CLINIC
  • Facility Address: 201 WEST CLINTON ST
    ROSEBORO, NC
    ZIP 28382
  • Facility Phone: 919 525-4062
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: EDDIE N. POWELL
  • NPI Number: 1285740142
  • Taxonomy: 170100000X - Medical Genetics, Ph.D. Medical Genetics

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CLIA Record

Field Name Field Value
CLIA Number 34D0877495
LAB Type Community Clinic
Facility Name POWELL'S MEDICAL CLINIC
Street 201 WEST CLINTON ST
City ROSEBORO
State NC
ZIP 28382
Phone 919 525-4062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Community Clinic
Lab Director EDDIE N. POWELL

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