34D0940480 CLIA NUMBER - PRIME CARE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 34D0940480
  • Facility Name: PRIME CARE MEDICAL CENTER
  • Facility Address: 3627 BEATTIES FORD ROAD
    CHARLOTTE, NC
    ZIP 28216
  • Facility Phone: 704 335-0807
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: PATRICK EVIVIE
  • NPI Number: 1013974864
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D0940480
LAB Type Physician Office
Facility Name PRIME CARE MEDICAL CENTER
Street 3627 BEATTIES FORD ROAD
City CHARLOTTE
State NC
ZIP 28216
Phone 704 335-0807
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/11/2024
Certificate Expiration Date 11/10/2026
Facility Type Physician Office
Lab Director PATRICK EVIVIE

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