34D1100790 CLIA NUMBER - GREENBRIAR PRIMARY CARE PA

Laboratory Demographics

  • CLIA Code: 34D1100790
  • Facility Name: GREENBRIAR PRIMARY CARE PA
  • Facility Address: 308-C MCKSVILLE HWY
    STATESVILLE, NC
    ZIP 28625
  • Facility Phone: 704 873-4484
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JUDY L. KEIGHRON
  • NPI Number: 1477789147
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 34D1100790
LAB Type Practitioner Other
Facility Name GREENBRIAR PRIMARY CARE PA
Street 308-C MCKSVILLE HWY
City STATESVILLE
State NC
ZIP 28625
Phone 704 873-4484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Practitioner Other
Lab Director JUDY L. KEIGHRON

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