34D2251475 CLIA NUMBER - MAINSTREET & KIDSSTREET OF NORTH CAROLINA, PLLC

Laboratory Demographics

  • CLIA Code: 34D2251475
  • Facility Name: MAINSTREET & KIDSSTREET OF NORTH CAROLINA, PLLC
  • Facility Address: 130 JAMES AVE
    LOCUST, NC
    ZIP 28097
  • Facility Phone: 205 545-5085
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: TIMOTHY P. TAYLOR
  • NPI Number: 1861010423
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2251475
LAB Type Other - URGENT CARE
Facility Name MAINSTREET & KIDSSTREET OF NORTH CAROLINA, PLLC
Street 130 JAMES AVE
City LOCUST
State NC
ZIP 28097
Phone 205 545-5085
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Other - URGENT CARE
Lab Director TIMOTHY P. TAYLOR

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