34D2292667 CLIA NUMBER - PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 34D2292667
  • Facility Name: PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC
  • Facility Address: 4857 DOGWOOD LANE
    LIBERTY, NC
    ZIP 27298
  • Facility Phone: 743 557-6960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NILAY PATEL
  • NPI Number: 1447997978
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2292667
LAB Type Physician Office
Facility Name PREMISE HEALTH OF NORTH CAROLINA MEDICAL, PC
Street 4857 DOGWOOD LANE
City LIBERTY
State NC
ZIP 27298
Phone 743 557-6960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director NILAY PATEL

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This page was last updated on: 3/20/2025