34D0911307 CLIA NUMBER - RICHARD A DOUGHERTY MD PA

Laboratory Demographics

CLIA Number: 34D0911307

Facility Name: RICHARD A DOUGHERTY MD PA

Facility Address:
10450 PARK RD STE 200
CHARLOTTE, NC
ZIP 28210
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Facility Phone Number: 704 541-9001

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1659344398

Taxonomy: 207Q00000X - Family Medicine
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.

CLIA Record

Field Name	Field Value
CLIA Number	34D0911307
LAB Type	Physician Office
Facility Name	RICHARD A DOUGHERTY MD PA
Street	10450 PARK RD STE 200
City	CHARLOTTE
State	NC
ZIP	28210
Phone	704 541-9001
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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