34D2319450 CLIA NUMBER - VITACORE LLC

Laboratory Demographics

  • CLIA Code: 34D2319450
  • Facility Name: VITACORE LLC
  • Facility Address: 375 SE BROAD ST
    SOUTHERN PINES, NC
    ZIP 28387
  • Facility Phone: 910 690-6894
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PHILIP MONDI
  • NPI Number: 1639987431
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2319450
LAB Type Physician Office
Facility Name VITACORE LLC
Street 375 SE BROAD ST
City SOUTHERN PINES
State NC
ZIP 28387
Phone 910 690-6894
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Physician Office
Lab Director DR. PHILIP MONDI

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