34D2156336 CLIA NUMBER - MOUNTAIN PEDIATRIC GROUP CANTON

Laboratory Demographics

  • CLIA Code: 34D2156336
  • Facility Name: MOUNTAIN PEDIATRIC GROUP CANTON
  • Facility Address: 55 BUCKEYE ROAD SUITE 200A
    CANTON, NC
    ZIP 28716
  • Facility Phone: 828 235-3023
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANNA MOONEY
  • NPI Number: 1124320932
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 34D2156336
LAB Type Physician Office
Facility Name MOUNTAIN PEDIATRIC GROUP CANTON
Street 55 BUCKEYE ROAD SUITE 200A
City CANTON
State NC
ZIP 28716
Phone 828 235-3023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director ANNA MOONEY

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