34D0899632 CLIA NUMBER - CAROLINA FAMILY CARE PA

Laboratory Demographics

CLIA Number: 34D0899632

Facility Name: CAROLINA FAMILY CARE PA

Facility Address:
707 WEST KING STREET
KINGS MOUNTAIN, NC
ZIP 28086
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Facility Phone Number: 704 734-0001

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295806305

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D0899632
LAB Type	Physician Office
Facility Name	CAROLINA FAMILY CARE PA
Street	707 WEST KING STREET
City	KINGS MOUNTAIN
State	NC
ZIP	28086
Phone	704 734-0001
CertificateType	4
CertificateEffectiveDate	6/15/2023
CertificateExpirationDate	6/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024