34D1020911 CLIA NUMBER - PEDIATRIC RESOURCE CENTER

Laboratory Demographics

  • CLIA Code: 34D1020911
  • Facility Name: PEDIATRIC RESOURCE CENTER
  • Facility Address: 901 EAST BOULEVARD
    CHARLOTTE, NC
    ZIP 28203
  • Facility Phone: 704 335-2763
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: KENDRA K. HAM
  • NPI Number: 1447573209
  • Taxonomy: 2088P0231X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D1020911
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PEDIATRIC RESOURCE CENTER
Street 901 EAST BOULEVARD
City CHARLOTTE
State NC
ZIP 28203
Phone 704 335-2763
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director KENDRA K. HAM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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