34D2283646 CLIA NUMBER - EQUITY HEALTH - PRIMARY CARE

Laboratory Demographics

CLIA Number: 34D2283646

Facility Name: EQUITY HEALTH - PRIMARY CARE

Facility Address:
275 NC -16 BUS, SUITE 104
DENVER, NC
ZIP 28037
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Facility Phone Number: 336 589-1223

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1649890450

Taxonomy: 363LA2200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	34D2283646
LAB Type	Physician Office
Facility Name	EQUITY HEALTH - PRIMARY CARE
Street	275 NC -16 BUS, SUITE 104
City	DENVER
State	NC
ZIP	28037
Phone	336 589-1223
CertificateType	4
CertificateEffectiveDate	6/12/2023
CertificateExpirationDate	6/11/2025
FacilityType	Waiver

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