34D2004683 CLIA NUMBER - RANDOLPH PRIMARY CARE, PA

Laboratory Demographics

  • CLIA Code: 34D2004683
  • Facility Name: RANDOLPH PRIMARY CARE, PA
  • Facility Address: 350 N COX STREET, SUITE 6
    ASHEBORO, NC
    ZIP 27203
  • Facility Phone: 336 629-2201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON J. VAN EYK
  • NPI Number: 1528392289
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 34D2004683
LAB Type Physician Office
Facility Name RANDOLPH PRIMARY CARE, PA
Street 350 N COX STREET, SUITE 6
City ASHEBORO
State NC
ZIP 27203
Phone 336 629-2201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director JASON J. VAN EYK

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