34D2041919 CLIA NUMBER - FAYETTEVILLE URGENT CARE

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Laboratory Demographics

CLIA Number: 34D2041919

Facility Name: FAYETTEVILLE URGENT CARE

Facility Address:
4155 FERNCREEK DRIVE, 102A
FAYETTEVILLE, NC
ZIP 28314
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Facility Phone Number: 910 425-5999

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1891060398

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2041919
LAB Type	Physician Office
Facility Name	FAYETTEVILLE URGENT CARE
Street	4155 FERNCREEK DRIVE, 102A
City	FAYETTEVILLE
State	NC
ZIP	28314
Phone	910 425-5999
CertificateType	3
CertificateEffectiveDate	12/26/2022
CertificateExpirationDate	12/25/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024