34D0961501 CLIA NUMBER - SOUTHFORK MEDICAL PARK

Laboratory Demographics

  • CLIA Code: 34D0961501
  • Facility Name: SOUTHFORK MEDICAL PARK
  • Facility Address: 1731 CONNELLY SPRINGS ROAD
    LENOIR, NC
    ZIP 28645
  • Facility Phone: 828 757-6300
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. JOHN POWELL
  • NPI Number: 1992701445
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D0961501
LAB Type Physician Office
Facility Name SOUTHFORK MEDICAL PARK
Street 1731 CONNELLY SPRINGS ROAD
City LENOIR
State NC
ZIP 28645
Phone 828 757-6300
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Physician Office
Lab Director DR. JOHN POWELL

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