34D2254983 CLIA NUMBER - ASHEBORO CRISIS CENTER - FBC OF RANDOLPH

Laboratory Demographics

CLIA Number: 34D2254983

Facility Name: ASHEBORO CRISIS CENTER - FBC OF RANDOLPH

Facility Address:
110 WEST WALKER AVE, 3RD FLOOR
ASHEBORO, NC
ZIP 27203
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Facility Phone Number: 336 466-5404

Facility Type: Other - FACILITY BASED CRISIS

Certificate Type: Waiver

NPI Number: 1245622026

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	34D2254983
LAB Type	Other - FACILITY BASED CRISIS
Facility Name	ASHEBORO CRISIS CENTER - FBC OF RANDOLPH
Street	110 WEST WALKER AVE, 3RD FLOOR
City	ASHEBORO
State	NC
ZIP	27203
Phone	336 466-5404
CertificateType	4
CertificateEffectiveDate	3/9/2024
CertificateExpirationDate	3/8/2026
FacilityType	Waiver

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