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34D0988627 CLIA NUMBER - LAKE NORMAN MEDICAL GROUP FAMILY MEDICINE TALL OAKS

Laboratory Demographics

CLIA Number: 34D0988627

Facility Name: LAKE NORMAN MEDICAL GROUP FAMILY MEDICINE TALL OAKS

Facility Address:
798 OAK RIDGE FARM ROAD, BLDG A
MOORESVILLE, NC
ZIP 28115
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Facility Phone Number: 704 658-0011

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1427015254

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 34D0988627
LAB Type Physician Office
Facility Name LAKE NORMAN MEDICAL GROUP FAMILY MEDICINE TALL OAKS
Street 798 OAK RIDGE FARM ROAD, BLDG A
City MOORESVILLE
State NC
ZIP 28115
Phone 704 658-0011
CertificateType 4
CertificateEffectiveDate 7/3/2023
CertificateExpirationDate 7/2/2025
FacilityType Waiver

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