34D0951691 CLIA NUMBER - WALLACE URGENT CARE, LLC

Laboratory Demographics

  • CLIA Code: 34D0951691
  • Facility Name: WALLACE URGENT CARE, LLC
  • Facility Address: 112 MEDICAL VILLAGE DRIVE, UNIT G
    WALLACE, NC
    ZIP 28466
  • Facility Phone: 910 552-1580
  • Facility Type: Other - URGENT CARE
  • Facility Type: Microscopy
  • Lab Director: DANIEL M. RICCI
  • NPI Number: 1841259025
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0951691
LAB Type Other - URGENT CARE
Facility Name WALLACE URGENT CARE, LLC
Street 112 MEDICAL VILLAGE DRIVE, UNIT G
City WALLACE
State NC
ZIP 28466
Phone 910 552-1580
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 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Other - URGENT CARE
Lab Director DANIEL M. RICCI

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