34D2137117 CLIA NUMBER - LOCKLEAR FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 34D2137117
  • Facility Name: LOCKLEAR FAMILY PRACTICE, PLLC
  • Facility Address: 17 LIVERMORE DR
    PEMBROKE, NC
    ZIP 28372
  • Facility Phone: (910) 827-3169
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JODELLA LOCKLEAR
  • NPI Number: 1932628187
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 34D2137117
LAB Type Practitioner Other
Facility Name LOCKLEAR FAMILY PRACTICE, PLLC
Street 17 LIVERMORE DR
City PEMBROKE
State NC
ZIP 28372
Phone 9108273169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Practitioner Other
Lab Director JODELLA LOCKLEAR

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This page was last updated on: 5/18/2026