34D2258920 CLIA NUMBER - IREDELL PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 34D2258920
  • Facility Name: IREDELL PRIMARY CARE
  • Facility Address: 114 GATEWAY BLVD, SUITE B
    MOORESVILLE, NC
    ZIP 28117
  • Facility Phone: 980 435-0406
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY D. ELKINS
  • NPI Number: 1861147779
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2258920
LAB Type Physician Office
Facility Name IREDELL PRIMARY CARE
Street 114 GATEWAY BLVD, SUITE B
City MOORESVILLE
State NC
ZIP 28117
Phone 980 435-0406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Physician Office
Lab Director ANTHONY D. ELKINS

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