34D1006468 CLIA NUMBER - ROBERSONVILLE PHYSICIANS PC

Laboratory Demographics

  • CLIA Code: 34D1006468
  • Facility Name: ROBERSONVILLE PHYSICIANS PC
  • Facility Address: 504 N MAIN ST
    ROBERSONVILLE, NC
    ZIP 27871
  • Facility Phone: 252 795-5555
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS J. GENNOSA
  • NPI Number: 1700075348
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1006468
LAB Type Physician Office
Facility Name ROBERSONVILLE PHYSICIANS PC
Street 504 N MAIN ST
City ROBERSONVILLE
State NC
ZIP 27871
Phone 252 795-5555
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 11/22/2024
Certificate Expiration Date 11/21/2026
Facility Type Physician Office
Lab Director THOMAS J. GENNOSA

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