34D0993418 CLIA NUMBER - GROWING CHILD PEDIATRICS AT WAKE FOREST

Laboratory Demographics

  • CLIA Code: 34D0993418
  • Facility Name: GROWING CHILD PEDIATRICS AT WAKE FOREST
  • Facility Address: 11130 CAPITAL BOULEVARD
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 845-0623
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOANNE WAGNER
  • NPI Number: 1639472186
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D0993418
LAB Type Physician Office
Facility Name GROWING CHILD PEDIATRICS AT WAKE FOREST
Street 11130 CAPITAL BOULEVARD
City WAKE FOREST
State NC
ZIP 27587
Phone 919 845-0623
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director JOANNE WAGNER

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