34D2288473 CLIA NUMBER - PINEHURST PLASTIC SURGERY SPECIALISTS, PA

Laboratory Demographics

CLIA Number: 34D2288473

Facility Name: PINEHURST PLASTIC SURGERY SPECIALISTS, PA

Facility Address:
20 MEMORIAL DR SUITE A
PINEHURST, NC
ZIP 28374
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Facility Phone Number: 910 295-1917

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437349636

Taxonomy: 2086S0122X - Surgery
A surgeon who specializes in plastic and reconstructive surgery.

CLIA Record

Field Name	Field Value
CLIA Number	34D2288473
LAB Type	Physician Office
Facility Name	PINEHURST PLASTIC SURGERY SPECIALISTS, PA
Street	20 MEMORIAL DR SUITE A
City	PINEHURST
State	NC
ZIP	28374
Phone	910 295-1917
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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