34D2235767 CLIA NUMBER - COVENANT PRIMARY & BEHAVIORAL CARE, PLLC

Laboratory Demographics

  • CLIA Code: 34D2235767
  • Facility Name: COVENANT PRIMARY & BEHAVIORAL CARE, PLLC
  • Facility Address: 812 CANY PARK RD SUITE 6101A
    PEMBROKE, NC
    ZIP 28372
  • Facility Phone: 910 778-5455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM J. JOHNSON
  • NPI Number: 1346816667
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2235767
LAB Type Physician Office
Facility Name COVENANT PRIMARY & BEHAVIORAL CARE, PLLC
Street 812 CANY PARK RD SUITE 6101A
City PEMBROKE
State NC
ZIP 28372
Phone 910 778-5455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Physician Office
Lab Director WILLIAM J. JOHNSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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