34D2113947 CLIA NUMBER - MID-CAROLINA OBSTETRICS & GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 34D2113947
  • Facility Name: MID-CAROLINA OBSTETRICS & GYNECOLOGY
  • Facility Address: 4414 LAKE BOONE TRAIL SUITE 300
    RALEIGH, NC
    ZIP 27607
  • Facility Phone: 919 781-5510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY O. GROFF
  • NPI Number: 1457311870
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 34D2113947
LAB Type Physician Office
Facility Name MID-CAROLINA OBSTETRICS & GYNECOLOGY
Street 4414 LAKE BOONE TRAIL SUITE 300
City RALEIGH
State NC
ZIP 27607
Phone 919 781-5510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Physician Office
Lab Director AMY O. GROFF

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