34D1073020 CLIA NUMBER - MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA

Laboratory Demographics

CLIA Number: 34D1073020

Facility Name: MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA

Facility Address:
609 RICHLANDS HWY STE 6
JACKSONVILLE, NC
ZIP 28540
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Facility Phone Number: 910 346-2273

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154815223

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D1073020
LAB Type	Physician Office
Facility Name	MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Street	609 RICHLANDS HWY STE 6
City	JACKSONVILLE
State	NC
ZIP	28540
Phone	910 346-2273
CertificateType	4
CertificateEffectiveDate	8/29/2023
CertificateExpirationDate	8/28/2025
FacilityType	Waiver

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