34D2240189 CLIA NUMBER - AZALEA COAST BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 34D2240189
  • Facility Name: AZALEA COAST BEHAVIORAL HEALTH
  • Facility Address: 3333 WRIGHTSVILLE AVE STE M
    WILMINGTON, NC
    ZIP 28403
  • Facility Phone: 910 399-3591
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PERIHAN S. WARREN
  • NPI Number: 1386100360
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 34D2240189
LAB Type Physician Office
Facility Name AZALEA COAST BEHAVIORAL HEALTH
Street 3333 WRIGHTSVILLE AVE STE M
City WILMINGTON
State NC
ZIP 28403
Phone 910 399-3591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director PERIHAN S. WARREN

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This page was last updated on: 3/20/2025