34D0906871 CLIA NUMBER - PELICAN HEALTH RANDOLPH

Laboratory Demographics

  • CLIA Code: 34D0906871
  • Facility Name: PELICAN HEALTH RANDOLPH
  • Facility Address: 4801 RANDOLPH RD
    CHARLOTTE, NC
    ZIP 28211
  • Facility Phone: 704 364-8363
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ZACH WOOD
  • NPI Number: 1962052498
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D0906871
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PELICAN HEALTH RANDOLPH
Street 4801 RANDOLPH RD
City CHARLOTTE
State NC
ZIP 28211
Phone 704 364-8363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2023
Certificate Expiration Date 10/4/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ZACH WOOD

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