34D2189928 CLIA NUMBER - LLIBOTT CONSULORIOS MEDICOS

Laboratory Demographics

  • CLIA Code: 34D2189928
  • Facility Name: LLIBOTT CONSULORIOS MEDICOS
  • Facility Address: 2000 AVONDALE DRIVE, UNIT #500
    DURHAM, NC
    ZIP 27704
  • Facility Phone: 336 792-1519
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALEJANDRA BUSTILLO
  • NPI Number: 1487030060
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2189928
LAB Type Physician Office
Facility Name LLIBOTT CONSULORIOS MEDICOS
Street 2000 AVONDALE DRIVE, UNIT #500
City DURHAM
State NC
ZIP 27704
Phone 336 792-1519
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 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Physician Office
Lab Director ALEJANDRA BUSTILLO

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