34D0972771 CLIA NUMBER - HOLLY SPRINGS FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 34D0972771
  • Facility Name: HOLLY SPRINGS FAMILY PRACTICE
  • Facility Address: 104 ARARAT-LONGHILL ROAD
    PILOT MOUNTAIN, NC
    ZIP 27041
  • Facility Phone: 336 786-7966
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RANDALL S. KEITH
  • NPI Number: 1346353869
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D0972771
LAB Type Physician Office
Facility Name HOLLY SPRINGS FAMILY PRACTICE
Street 104 ARARAT-LONGHILL ROAD
City PILOT MOUNTAIN
State NC
ZIP 27041
Phone 336 786-7966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director RANDALL S. KEITH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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