34D0891704 CLIA NUMBER - FIRSTHEALTH FAMILY CARE CENTER-ELLERBE

Laboratory Demographics

  • CLIA Code: 34D0891704
  • Facility Name: FIRSTHEALTH FAMILY CARE CENTER-ELLERBE
  • Facility Address: 112 EAST BALLARD STREET
    ELLERBE, NC
    ZIP 28338
  • Facility Phone: 910 817-4060
  • Facility Type: Other - HOSPITAL OWNED CLINIC
  • Facility Type: Waiver
  • Lab Director: BOHDAN W. KOPYNEC MD
  • NPI Number: 1336154129
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0891704
LAB Type Other - HOSPITAL OWNED CLINIC
Facility Name FIRSTHEALTH FAMILY CARE CENTER-ELLERBE
Street 112 EAST BALLARD STREET
City ELLERBE
State NC
ZIP 28338
Phone 910 817-4060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Other - HOSPITAL OWNED CLINIC
Lab Director BOHDAN W. KOPYNEC MD

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