34D0940480 CLIA NUMBER - PRIME CARE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 34D0940480

Facility Name: PRIME CARE MEDICAL CENTER

Facility Address:
3627 BEATTIES FORD ROAD
CHARLOTTE, NC
ZIP 28216
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Facility Phone Number: 704 335-0807

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1013974864

Taxonomy: 261QP2300X - Clinic/Center

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
CertificateType	1
CertificateEffectiveDate	11/11/2022
CertificateExpirationDate	11/10/2024
FacilityType	Accreditation

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