34D2315570 CLIA NUMBER - SOUTHEASTERN INTEGRATED CARE, LLC./ CANDOR

Laboratory Demographics

  • CLIA Code: 34D2315570
  • Facility Name: SOUTHEASTERN INTEGRATED CARE, LLC./ CANDOR
  • Facility Address: 110 EAST BLAKE STREET
    CANDOR, NC
    ZIP 27229
  • Facility Phone: 910 522-0408
  • Facility Type: Other - MENTAL HEALTH AGENCY
  • Facility Type: Waiver
  • Lab Director: NANCI BREWINGTON
  • NPI Number: 1801580485
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 34D2315570
LAB Type Other - MENTAL HEALTH AGENCY
Facility Name SOUTHEASTERN INTEGRATED CARE, LLC./ CANDOR
Street 110 EAST BLAKE STREET
City CANDOR
State NC
ZIP 27229
Phone 910 522-0408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Other - MENTAL HEALTH AGENCY
Lab Director NANCI BREWINGTON

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