34D2103780 CLIA NUMBER - AMN MEDICAL GROUP PLLC DBA WAKE HEALTH MEDICAL GROUP

Laboratory Demographics

CLIA Number: 34D2103780

Facility Name: AMN MEDICAL GROUP PLLC DBA WAKE HEALTH MEDICAL GROUP

Facility Address:
13200 NEW FALLS OF THE NEUSE ROAD SUITE 113
RALEIGH, NC
ZIP 27614
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Facility Phone Number: 919 554-6754

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538652557

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	34D2103780
LAB Type	Physician Office
Facility Name	AMN MEDICAL GROUP PLLC DBA WAKE HEALTH MEDICAL GROUP
Street	13200 NEW FALLS OF THE NEUSE ROAD SUITE 113
City	RALEIGH
State	NC
ZIP	27614
Phone	919 554-6754
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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