34D2149876 CLIA NUMBER - ST LUKE'S MEDICAL PRACTICE

Laboratory Demographics

CLIA Number: 34D2149876

Facility Name: ST LUKE'S MEDICAL PRACTICE

Facility Address:
334 MILL CREEK ROAD, SUITE D
CARTHAGE, NC
ZIP 28327
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Facility Phone Number: 910 725-0809

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760859516

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	34D2149876
LAB Type	Physician Office
Facility Name	ST LUKE'S MEDICAL PRACTICE
Street	334 MILL CREEK ROAD, SUITE D
City	CARTHAGE
State	NC
ZIP	28327
Phone	910 725-0809
CertificateType	4
CertificateEffectiveDate	6/12/2022
CertificateExpirationDate	6/11/2024
FacilityType	Waiver

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