34D2019909 CLIA NUMBER - MAIN STREET FAMILY PRACTICE OF CHINA GROVE PC

Laboratory Demographics

  • CLIA Code: 34D2019909
  • Facility Name: MAIN STREET FAMILY PRACTICE OF CHINA GROVE PC
  • Facility Address: 302 S MAIN STREET
    CHINA GROVE, NC
    ZIP 28023
  • Facility Phone: (704) 857-8769
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ORRIN A. WALKER
  • NPI Number: 1619279247
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2019909
LAB Type Physician Office
Facility Name MAIN STREET FAMILY PRACTICE OF CHINA GROVE PC
Street 302 S MAIN STREET
City CHINA GROVE
State NC
ZIP 28023
Phone 7048578769
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Physician Office
Lab Director ORRIN A. WALKER

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This page was last updated on: 6/29/2026