34D0978258 CLIA NUMBER - LUMBERTON INTERNAL MEDICINE GROUP

Laboratory Demographics

  • CLIA Code: 34D0978258
  • Facility Name: LUMBERTON INTERNAL MEDICINE GROUP
  • Facility Address: 4314 LUDGATE STREET
    LUMBERTON, NC
    ZIP 28358
  • Facility Phone: 910 272-8800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAC A. MONTILUS
  • NPI Number: 1376647073
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 34D0978258
LAB Type Physician Office
Facility Name LUMBERTON INTERNAL MEDICINE GROUP
Street 4314 LUDGATE STREET
City LUMBERTON
State NC
ZIP 28358
Phone 910 272-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director MAC A. MONTILUS

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