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34D1060092 CLIA NUMBER - BLUE RIDGE ENT & ALLERGY

Laboratory Demographics

CLIA Number: 34D1060092

Facility Name: BLUE RIDGE ENT & ALLERGY

Facility Address:
352 EAST PARKER ROAD, SUITE B
MORGANTON, NC
ZIP 28655
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Facility Phone Number: 828 433-6410

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1083854251

Taxonomy: 207YX0007X - Otolaryngology
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

CLIA Record

Field Name Field Value
CLIA Number 34D1060092
LAB Type Physician Office
Facility Name BLUE RIDGE ENT & ALLERGY
Street 352 EAST PARKER ROAD, SUITE B
City MORGANTON
State NC
ZIP 28655
Phone 828 433-6410
CertificateType 4
CertificateEffectiveDate 6/20/2023
CertificateExpirationDate 6/19/2025
FacilityType Waiver

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