34D0882800 CLIA NUMBER - BLUE RIDGE CARDIOLOGY & INTERNAL MED

Laboratory Demographics

CLIA Number: 34D0882800

Facility Name: BLUE RIDGE CARDIOLOGY & INTERNAL MED

Facility Address:
640 PARKWOOD MEDICAL PARK
ELKIN, NC
ZIP 28621
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Facility Phone Number: 910 526-7997

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1912092867

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	34D0882800
LAB Type	Physician Office
Facility Name	BLUE RIDGE CARDIOLOGY & INTERNAL MED
Street	640 PARKWOOD MEDICAL PARK
City	ELKIN
State	NC
ZIP	28621
Phone	910 526-7997
CertificateType	4
CertificateEffectiveDate	2/18/2024
CertificateExpirationDate	2/17/2026
FacilityType	Waiver

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