34D1051327 CLIA NUMBER - GOSHEN MEDICAL CENTER - BOLTON

Laboratory Demographics

CLIA Number: 34D1051327

Facility Name: GOSHEN MEDICAL CENTER - BOLTON

Facility Address:
213 9TH STREET
BOLTON, NC
ZIP 28423
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Facility Phone Number: 910 655-8300

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1164695375

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D1051327
LAB Type	Physician Office
Facility Name	GOSHEN MEDICAL CENTER - BOLTON
Street	213 9TH STREET
City	BOLTON
State	NC
ZIP	28423
Phone	910 655-8300
CertificateType	3
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	PPMP

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