34D2295901 CLIA NUMBER - ENC PEDS PLLC

Laboratory Demographics

  • CLIA Code: 34D2295901
  • Facility Name: ENC PEDS PLLC
  • Facility Address: 222B VIRGINIA ROAD
    EDENTON, NC
    ZIP 27932
  • Facility Phone: 252 484-9024
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRYAN L. IAN
  • NPI Number: 1518692797
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2295901
LAB Type Physician Office
Facility Name ENC PEDS PLLC
Street 222B VIRGINIA ROAD
City EDENTON
State NC
ZIP 27932
Phone 252 484-9024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Physician Office
Lab Director BRYAN L. IAN

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