34D2315130 CLIA NUMBER - PHLEBOTOMY QUEENS MOBILE SERVICE, LLC

Laboratory Demographics

  • CLIA Code: 34D2315130
  • Facility Name: PHLEBOTOMY QUEENS MOBILE SERVICE, LLC
  • Facility Address: 8601 SIX FORKS ROAD STE 400
    RALEIGH, NC
    ZIP 27615
  • Facility Phone: 919 579-1316
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ASHLEY RIVERA
  • NPI Number: 1538984364
  • Taxonomy: 246RP1900X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 34D2315130
LAB Type Mobile Laboratory
Facility Name PHLEBOTOMY QUEENS MOBILE SERVICE, LLC
Street 8601 SIX FORKS ROAD STE 400
City RALEIGH
State NC
ZIP 27615
Phone 919 579-1316
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2024
Certificate Expiration Date 12/5/2026
Facility Type Mobile Laboratory
Lab Director ASHLEY RIVERA

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