34D1092372 CLIA NUMBER - NORTHWOOD MEDICAL CENTER PA

Laboratory Demographics

CLIA Number: 34D1092372

Facility Name: NORTHWOOD MEDICAL CENTER PA

Facility Address:
116 COUNTRY CLUB DRIVE
FAYETTEVILLE, NC
ZIP 28301
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Facility Phone Number: 910 488-0157

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164688032

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D1092372
LAB Type	Physician Office
Facility Name	NORTHWOOD MEDICAL CENTER PA
Street	116 COUNTRY CLUB DRIVE
City	FAYETTEVILLE
State	NC
ZIP	28301
Phone	910 488-0157
CertificateType	4
CertificateEffectiveDate	11/24/2022
CertificateExpirationDate	11/23/2024
FacilityType	Waiver

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