34D2249824 CLIA NUMBER - MEDICINE PARK PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2249824
  • Facility Name: MEDICINE PARK PHARMACY
  • Facility Address: 100 PARK AVE
    SANFORD, NC
    ZIP 27330
  • Facility Phone: 919 776-9715
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAVIKUMAR SOMEPALLI
  • NPI Number: 1255315909
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2249824
LAB Type Pharmacy
Facility Name MEDICINE PARK PHARMACY
Street 100 PARK AVE
City SANFORD
State NC
ZIP 27330
Phone 919 776-9715
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Pharmacy
Lab Director RAVIKUMAR SOMEPALLI

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