34D2191423 CLIA NUMBER - RALEIGH COMPREHENSIVE & COSMETIC DENTISTRY

Laboratory Demographics

  • CLIA Code: 34D2191423
  • Facility Name: RALEIGH COMPREHENSIVE & COSMETIC DENTISTRY
  • Facility Address: 119 N BOYLAN AVENUE
    RALEIGH, NC
    ZIP 27603
  • Facility Phone: 919 828-3775
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ROBERT L. WILLIAMSON III
  • NPI Number: 1144338799
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 34D2191423
LAB Type Practitioner Other
Facility Name RALEIGH COMPREHENSIVE & COSMETIC DENTISTRY
Street 119 N BOYLAN AVENUE
City RALEIGH
State NC
ZIP 27603
Phone 919 828-3775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Practitioner Other
Lab Director ROBERT L. WILLIAMSON III

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