34D1086482 CLIA NUMBER - ECU HEALTH MEDICAL CENTER- EHPC SMAT

Laboratory Demographics

  • CLIA Code: 34D1086482
  • Facility Name: ECU HEALTH MEDICAL CENTER- EHPC SMAT
  • Facility Address: 2100 STANTONSBURG ROAD
    GREENVILLE, NC
    ZIP 27835
  • Facility Phone: 252 847-6634
  • Facility Type: Other - STATE MEDICAL ASSISTANCE
  • Facility Type: Waiver
  • Lab Director: ANDREA K. LATHAM
  • NPI Number: 1477648731
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1086482
LAB Type Other - STATE MEDICAL ASSISTANCE
Facility Name ECU HEALTH MEDICAL CENTER- EHPC SMAT
Street 2100 STANTONSBURG ROAD
City GREENVILLE
State NC
ZIP 27835
Phone 252 847-6634
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Other - STATE MEDICAL ASSISTANCE
Lab Director ANDREA K. LATHAM

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