34D2045407 CLIA NUMBER - WILSON COMMUNITY FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 34D2045407
  • Facility Name: WILSON COMMUNITY FAMILY PRACTICE, PLLC
  • Facility Address: 110 BRENTWOOD CENTER LANE N
    WILSON, NC
    ZIP 27896
  • Facility Phone: 252 991-5382
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANELLE BROWN-TAFT
  • NPI Number: 1801143805
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2045407
LAB Type Physician Office
Facility Name WILSON COMMUNITY FAMILY PRACTICE, PLLC
Street 110 BRENTWOOD CENTER LANE N
City WILSON
State NC
ZIP 27896
Phone 252 991-5382
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director JANELLE BROWN-TAFT

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