34D2172122 CLIA NUMBER - WAKEMED PRIMARY CARE- MORRISVILLE MEDICAL PARK

Laboratory Demographics

  • CLIA Code: 34D2172122
  • Facility Name: WAKEMED PRIMARY CARE- MORRISVILLE MEDICAL PARK
  • Facility Address: 101 HOLLY CREEK RD STE # 200
    MORRISVILLE, NC
    ZIP 27560
  • Facility Phone: 919 350-7180
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JACQUELINE HICKS
  • NPI Number: 1427604149
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2172122
LAB Type Physician Office
Facility Name WAKEMED PRIMARY CARE- MORRISVILLE MEDICAL PARK
Street 101 HOLLY CREEK RD STE # 200
City MORRISVILLE
State NC
ZIP 27560
Phone 919 350-7180
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Physician Office
Lab Director JACQUELINE HICKS

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