34D1000504 CLIA NUMBER - CONCENTRA URGENT CARE

Laboratory Demographics

  • CLIA Code: 34D1000504
  • Facility Name: CONCENTRA URGENT CARE
  • Facility Address: 1614 SOUTH BLVD
    CHARLOTTE, NC
    ZIP 28203
  • Facility Phone: 704 338-1268
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD ELSEY
  • NPI Number: 1578715041
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1000504
LAB Type Physician Office
Facility Name CONCENTRA URGENT CARE
Street 1614 SOUTH BLVD
City CHARLOTTE
State NC
ZIP 28203
Phone 704 338-1268
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Physician Office
Lab Director RICHARD ELSEY

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