34D0941192 CLIA NUMBER - CHARLOTTE EYE EAR NOSE & THROAT ASSOCS PA

Laboratory Demographics

  • CLIA Code: 34D0941192
  • Facility Name: CHARLOTTE EYE EAR NOSE & THROAT ASSOCS PA
  • Facility Address: 400 PARK STREET
    BELMONT, NC
    ZIP 28012
  • Facility Phone: 704 295-3700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KASHYAP B. KANSUPADA
  • NPI Number: 1588130496
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 34D0941192
LAB Type Physician Office
Facility Name CHARLOTTE EYE EAR NOSE & THROAT ASSOCS PA
Street 400 PARK STREET
City BELMONT
State NC
ZIP 28012
Phone 704 295-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Physician Office
Lab Director KASHYAP B. KANSUPADA

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