34D2006245 CLIA NUMBER - JOHNSTON THERAPEUTIC WOUND CTR OF JOHNSTON MED CTR

Laboratory Demographics

  • CLIA Code: 34D2006245
  • Facility Name: JOHNSTON THERAPEUTIC WOUND CTR OF JOHNSTON MED CTR
  • Facility Address: 514 NORTH BRIGHTLEAF BOULEVARD
    SMITHFIELD, NC
    ZIP 27577
  • Facility Phone: 919 938-7716
  • Facility Type: Other - THERAP WOUND CTR
  • Facility Type: Waiver
  • Lab Director: MANMOHAN SINGH
  • NPI Number: 1427254598
  • Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities

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CLIA Record

Field Name Field Value
CLIA Number 34D2006245
LAB Type Other - THERAP WOUND CTR
Facility Name JOHNSTON THERAPEUTIC WOUND CTR OF JOHNSTON MED CTR
Street 514 NORTH BRIGHTLEAF BOULEVARD
City SMITHFIELD
State NC
ZIP 27577
Phone 919 938-7716
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Other - THERAP WOUND CTR
Lab Director MANMOHAN SINGH

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