34D1092376 CLIA NUMBER - CAPE FEAR VALLEY OUTPATIENT IMAGING CENTER - FAYETTEVILLE

Laboratory Demographics

  • CLIA Code: 34D1092376
  • Facility Name: CAPE FEAR VALLEY OUTPATIENT IMAGING CENTER - FAYETTEVILLE
  • Facility Address: 3186 VILLAGE DRIVE STE 101
    FAYETTEVILLE, NC
    ZIP 28304
  • Facility Phone: 910 323-2209
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA CARR- JOHNSON
  • NPI Number: 1245474022
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 34D1092376
LAB Type Physician Office
Facility Name CAPE FEAR VALLEY OUTPATIENT IMAGING CENTER - FAYETTEVILLE
Street 3186 VILLAGE DRIVE STE 101
City FAYETTEVILLE
State NC
ZIP 28304
Phone 910 323-2209
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Physician Office
Lab Director SANDRA CARR- JOHNSON

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