34D2311145 CLIA NUMBER - WAKEMED CHILDREN'S-PEDIATRIC PRIMARY CARE- WAKE FOREST MEDICAL PARK

Laboratory Demographics

  • CLIA Code: 34D2311145
  • Facility Name: WAKEMED CHILDREN'S-PEDIATRIC PRIMARY CARE- WAKE FOREST MEDICAL PARK
  • Facility Address: 1030 SIENA DR.
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 350-7180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIZABETH B. CLELAND-ROBERTS
  • NPI Number: 1891543864
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D2311145
LAB Type Physician Office
Facility Name WAKEMED CHILDREN'S-PEDIATRIC PRIMARY CARE- WAKE FOREST MEDICAL PARK
Street 1030 SIENA DR.
City WAKE FOREST
State NC
ZIP 27587
Phone 919 350-7180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director ELIZABETH B. CLELAND-ROBERTS

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