34D2310135 CLIA NUMBER - KIDMED PLLC

Laboratory Demographics

  • CLIA Code: 34D2310135
  • Facility Name: KIDMED PLLC
  • Facility Address: 1165 CEDAR POINT BOULEVARD SUITE F
    CEDAR POINT, NC
    ZIP 28584
  • Facility Phone: 910 340-1521
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY R. DURHAM
  • NPI Number: 1306684642
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 34D2310135
LAB Type Physician Office
Facility Name KIDMED PLLC
Street 1165 CEDAR POINT BOULEVARD SUITE F
City CEDAR POINT
State NC
ZIP 28584
Phone 910 340-1521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Physician Office
Lab Director KELLY R. DURHAM

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