PRIVATE DIAGNOSTIC CLINIC PLLC NPI 1972826568

NPI Information

  • NPI: 1972826568
  • Provider Name: PRIVATE DIAGNOSTIC CLINIC, PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: SOUTHERN HIGH WELLNESS CTR.
  • CLIA Number: 34D0913719
  • Address: 800 CLAYTON RD
    DURHAM, NC
    ZIP 27703
  • Phone: (919) 560-2536

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NPI Details

PRIVATE DIAGNOSTIC CLINIC, PLLC is a family medicine in Durham, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PRIVATE DIAGNOSTIC CLINIC, PLLC NPI is 1972826568. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southern High Wellness Ctr..

The provider's business location address is:

800 CLAYTON RD
DURHAM, NC
ZIP 27703-606
Phone: (919) 560-2536

The provider's authorized official is Christopher Thomas Frederick .
The authorized official title is Cfo and has the following contact phone number (919) 613-7762.

The CLIA number assigned to this NPI record is 34D0913719 - school/student health service with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/10/2010 and was last updated on 7/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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