34D2079258 CLIA NUMBER - GOSHEN MEDICAL CENTER - CAPE FEAR

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Laboratory Demographics

CLIA Number: 34D2079258

Facility Name: GOSHEN MEDICAL CENTER - CAPE FEAR

Facility Address:
3613 CAPE CENTER DRIVE
FAYETTEVILLE, NC
ZIP 28304
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Facility Phone Number: 910 354-1720

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1215366216

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2079258
LAB Type	Federally Qualified Health Center
Facility Name	GOSHEN MEDICAL CENTER - CAPE FEAR
Street	3613 CAPE CENTER DRIVE
City	FAYETTEVILLE
State	NC
ZIP	28304
Phone	910 354-1720
CertificateType	3
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	PPMP

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