34D2328806 CLIA NUMBER - BEACH PRIMARY CARE AND WELLNESS, PLLC

Laboratory Demographics

  • CLIA Code: 34D2328806
  • Facility Name: BEACH PRIMARY CARE AND WELLNESS, PLLC
  • Facility Address: 863 OCEAN HWY W
    SUPPLY, NC
    ZIP 28462
  • Facility Phone: 910 995-7022
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARY R. CRICHTON
  • NPI Number: 1053103796
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2328806
LAB Type Practitioner Other
Facility Name BEACH PRIMARY CARE AND WELLNESS, PLLC
Street 863 OCEAN HWY W
City SUPPLY
State NC
ZIP 28462
Phone 910 995-7022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Practitioner Other
Lab Director MARY R. CRICHTON

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