34D2193562 CLIA NUMBER - ATLANTIC FAMILY MED

Laboratory Demographics

  • CLIA Code: 34D2193562
  • Facility Name: ATLANTIC FAMILY MED
  • Facility Address: 819 N ATLANTIC AVENUE
    SOUTHPORT, NC
    ZIP 28461
  • Facility Phone: 910 454-4635
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SARAH L. WARD
  • NPI Number: 1073770939
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 34D2193562
LAB Type Physician Office
Facility Name ATLANTIC FAMILY MED
Street 819 N ATLANTIC AVENUE
City SOUTHPORT
State NC
ZIP 28461
Phone 910 454-4635
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 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director SARAH L. WARD

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