34D2081124 CLIA NUMBER - IREDELL AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 34D2081124
  • Facility Name: IREDELL AMBULATORY SURGERY CENTER
  • Facility Address: 701 BRYANT STREET
    STATESVILLE, NC
    ZIP 28677
  • Facility Phone: 704 380-2711
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ALAN E. DEDDENS
  • NPI Number: 1578073631
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2081124
LAB Type Ambulatory Surgery Center
Facility Name IREDELL AMBULATORY SURGERY CENTER
Street 701 BRYANT STREET
City STATESVILLE
State NC
ZIP 28677
Phone 704 380-2711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Ambulatory Surgery Center
Lab Director ALAN E. DEDDENS

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