34D0985922 CLIA NUMBER - CENTRE OB/GYN

Laboratory Demographics

  • CLIA Code: 34D0985922
  • Facility Name: CENTRE OB/GYN
  • Facility Address: 4414 LAKE BOONE TRAIL STE 205
    RALEIGH, NC
    ZIP 27607
  • Facility Phone: 919 788-4444
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEROME GARDNER MD
  • NPI Number: 1457752305
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 34D0985922
LAB Type Physician Office
Facility Name CENTRE OB/GYN
Street 4414 LAKE BOONE TRAIL STE 205
City RALEIGH
State NC
ZIP 27607
Phone 919 788-4444
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 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director JEROME GARDNER MD

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