34D2148097 CLIA NUMBER - TARHEEL FOOT & SPECIALTY CARE PA

Laboratory Demographics

CLIA Number: 34D2148097

Facility Name: TARHEEL FOOT & SPECIALTY CARE PA

Facility Address:
300 BIRCH STREET
RAEFORD, NC
ZIP 28376
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Facility Phone Number: 910 904-6600

Facility Type: Other - MULTISPECIALTY CLINIC

Certificate Type: Waiver

NPI Number: 1245780303

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	34D2148097
LAB Type	Other - MULTISPECIALTY CLINIC
Facility Name	TARHEEL FOOT & SPECIALTY CARE PA
Street	300 BIRCH STREET
City	RAEFORD
State	NC
ZIP	28376
Phone	910 904-6600
CertificateType	4
CertificateEffectiveDate	5/3/2024
CertificateExpirationDate	5/2/2026
FacilityType	Waiver

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