34D1037202 CLIA NUMBER - PRIMARY MEDICAL CARE

Laboratory Demographics

CLIA Number: 34D1037202

Facility Name: PRIMARY MEDICAL CARE

Facility Address:
270 CORNERSTONE DR STE 105
CARY, NC
ZIP 27519
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Facility Phone Number: 919 460-7676

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861822793

Taxonomy: 207QA0000X - Family Medicine
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	34D1037202
LAB Type	Physician Office
Facility Name	PRIMARY MEDICAL CARE
Street	270 CORNERSTONE DR STE 105
City	CARY
State	NC
ZIP	27519
Phone	919 460-7676
CertificateType	4
CertificateEffectiveDate	2/17/2023
CertificateExpirationDate	2/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024