34D2160190 CLIA NUMBER - SELECT FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 34D2160190
  • Facility Name: SELECT FAMILY PRACTICE
  • Facility Address: 10931 #115 RAVEN RIDGE ROAD
    RALEIGH, NC
    ZIP 27614
  • Facility Phone: 919 676-0202
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REZA HATEFI
  • NPI Number: 1124501085
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2160190
LAB Type Physician Office
Facility Name SELECT FAMILY PRACTICE
Street 10931 #115 RAVEN RIDGE ROAD
City RALEIGH
State NC
ZIP 27614
Phone 919 676-0202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Physician Office
Lab Director REZA HATEFI

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