34D2254529 CLIA NUMBER - THE HEALTH AND WELLNESS CENTER OF LUMBERTON, PLLC

Laboratory Demographics

CLIA Number: 34D2254529

Facility Name: THE HEALTH AND WELLNESS CENTER OF LUMBERTON, PLLC

Facility Address:
581 FARRINGDOM STREET
LUMBERTON, NC
ZIP 28358
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Facility Phone Number: 910 593-6267

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1790436228

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	34D2254529
LAB Type	Practitioner Other
Facility Name	THE HEALTH AND WELLNESS CENTER OF LUMBERTON, PLLC
Street	581 FARRINGDOM STREET
City	LUMBERTON
State	NC
ZIP	28358
Phone	910 593-6267
CertificateType	4
CertificateEffectiveDate	3/4/2024
CertificateExpirationDate	3/3/2026
FacilityType	Waiver

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