34D2258017 CLIA NUMBER - GOSHEN MEDICAL CENTER - ELIZABETHTOWN

Laboratory Demographics

CLIA Number: 34D2258017

Facility Name: GOSHEN MEDICAL CENTER - ELIZABETHTOWN

Facility Address:
400 MERCER MILL ROAD
ELIZABETHTOWN, NC
ZIP 28337
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Facility Phone Number: 910 879-3216

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1982357943

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2258017
LAB Type	Federally Qualified Health Center
Facility Name	GOSHEN MEDICAL CENTER - ELIZABETHTOWN
Street	400 MERCER MILL ROAD
City	ELIZABETHTOWN
State	NC
ZIP	28337
Phone	910 879-3216
CertificateType	3
CertificateEffectiveDate	4/14/2024
CertificateExpirationDate	4/13/2026
FacilityType	PPMP

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