34D2323866 CLIA NUMBER - PROACTIVE DX/MAKO MEDICAL LABORATORIES

Laboratory Demographics

  • CLIA Code: 34D2323866
  • Facility Name: PROACTIVE DX/MAKO MEDICAL LABORATORIES
  • Facility Address: 4901 GLENWOOD AVE SUITE 300
    RALEIGH, NC
    ZIP 27612
  • Facility Phone: 912 401-8303
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: PAUL E. COWSAR
  • NPI Number: 1134366743
  • Taxonomy: 111N00000X - Chiropractor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2323866
LAB Type Mobile Laboratory
Facility Name PROACTIVE DX/MAKO MEDICAL LABORATORIES
Street 4901 GLENWOOD AVE SUITE 300
City RALEIGH
State NC
ZIP 27612
Phone 912 401-8303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Mobile Laboratory
Lab Director PAUL E. COWSAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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