34D1104386 CLIA NUMBER - DAVIS GROVE PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 34D1104386
  • Facility Name: DAVIS GROVE PEDIATRICS PLLC
  • Facility Address: 204 DAVIS GROVE CIRCLE STE 107
    CARY, NC
    ZIP 27519
  • Facility Phone: 919 363-3427
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZHAO MIN
  • NPI Number: 1457718835
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D1104386
LAB Type Physician Office
Facility Name DAVIS GROVE PEDIATRICS PLLC
Street 204 DAVIS GROVE CIRCLE STE 107
City CARY
State NC
ZIP 27519
Phone 919 363-3427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director ZHAO MIN

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