34D2164382 CLIA NUMBER - MARSHIRL LOCKLEAR - FNP, PLLC

Laboratory Demographics

CLIA Number: 34D2164382

Facility Name: MARSHIRL LOCKLEAR - FNP, PLLC

Facility Address:
4303 LUDGATE ST
LUMBERTON, NC
ZIP 28358
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Facility Phone Number: 910 338-4593

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1265992713

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	34D2164382
LAB Type	Practitioner Other
Facility Name	MARSHIRL LOCKLEAR - FNP, PLLC
Street	4303 LUDGATE ST
City	LUMBERTON
State	NC
ZIP	28358
Phone	910 338-4593
CertificateType	3
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	PPMP

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