34D2192495 CLIA NUMBER - WAKEMED MYCARE 365 PRIMARY & URGENT CARE WAKE FOREST

Laboratory Demographics

  • CLIA Code: 34D2192495
  • Facility Name: WAKEMED MYCARE 365 PRIMARY & URGENT CARE WAKE FOREST
  • Facility Address: 2001 S MAIN STREET
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 350-7180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL Y. HONG
  • NPI Number: 1245820091
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 34D2192495
LAB Type Physician Office
Facility Name WAKEMED MYCARE 365 PRIMARY & URGENT CARE WAKE FOREST
Street 2001 S MAIN STREET
City WAKE FOREST
State NC
ZIP 27587
Phone 919 350-7180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director MICHAEL Y. HONG

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