34D0911307 CLIA NUMBER - RICHARD A DOUGHERTY MD PA

Laboratory Demographics

  • CLIA Code: 34D0911307
  • Facility Name: RICHARD A DOUGHERTY MD PA
  • Facility Address: 10450 PARK RD STE 200
    CHARLOTTE, NC
    ZIP 28210
  • Facility Phone: 704 541-9001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD A. DOUGHERTY MD
  • NPI Number: 1659344398
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director RICHARD A. DOUGHERTY MD

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