34D2063218 CLIA NUMBER - PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC

Home > CLIA Lookup > 34D2063218

Laboratory Demographics

CLIA Number: 34D2063218

Facility Name: PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC

Facility Address:
40589 SOUTH STANLY SCHOOL ROAD
NORWOOD, NC
ZIP 28128
Get Directions

Facility Phone Number: 704 474-2006

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124452586

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2063218
LAB Type	Physician Office
Facility Name	PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC
Street	40589 SOUTH STANLY SCHOOL ROAD
City	NORWOOD
State	NC
ZIP	28128
Phone	704 474-2006
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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