34D2234563 CLIA NUMBER - PINEHURST MEDICAL CLINIC AT AVIEMORE DRIVE

Laboratory Demographics

CLIA Number: 34D2234563

Facility Name: PINEHURST MEDICAL CLINIC AT AVIEMORE DRIVE

Facility Address:
45 AVIEMORE DRIVE
PINEHURST, NC
ZIP 28374
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Facility Phone Number: 910 235-3285

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194757583

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	34D2234563
LAB Type	Physician Office
Facility Name	PINEHURST MEDICAL CLINIC AT AVIEMORE DRIVE
Street	45 AVIEMORE DRIVE
City	PINEHURST
State	NC
ZIP	28374
Phone	910 235-3285
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024