34D2017226 CLIA NUMBER - COASTAL HORIZONS CENTER INC

Laboratory Demographics

  • CLIA Code: 34D2017226
  • Facility Name: COASTAL HORIZONS CENTER INC
  • Facility Address: 613 SHIPYARD BLVD, SUITE 106
    WILMINGTON, NC
    ZIP 28412
  • Facility Phone: 910 202-3860
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: JENNIFER M. NOMIDES
  • NPI Number: 1922483874
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 34D2017226
LAB Type Practitioner Other
Facility Name COASTAL HORIZONS CENTER INC
Street 613 SHIPYARD BLVD, SUITE 106
City WILMINGTON
State NC
ZIP 28412
Phone 910 202-3860
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Practitioner Other
Lab Director JENNIFER M. NOMIDES

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