34D2167034 CLIA NUMBER - PRIME SURGICAL SUITES, LLC

Laboratory Demographics

CLIA Number: 34D2167034

Facility Name: PRIME SURGICAL SUITES, LLC

Facility Address:
180 RIVER BEND DRIVE
GRANITE FALLS, NC
ZIP 28630
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Facility Phone Number: 828 757-5100

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1437623626

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2167034
LAB Type	Ambulatory Surgery Center
Facility Name	PRIME SURGICAL SUITES, LLC
Street	180 RIVER BEND DRIVE
City	GRANITE FALLS
State	NC
ZIP	28630
Phone	828 757-5100
CertificateType	4
CertificateEffectiveDate	5/31/2023
CertificateExpirationDate	5/30/2025
FacilityType	Waiver

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