34D1056491 CLIA NUMBER - CAROLINA PHYSICIANS GROUP PC

Laboratory Demographics

  • CLIA Code: 34D1056491
  • Facility Name: CAROLINA PHYSICIANS GROUP PC
  • Facility Address: 7615 COLONY RD STE 115
    CHARLOTTE, NC
    ZIP 28226
  • Facility Phone: 704 626-6812
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAY FERNANDO
  • NPI Number: 1538199567
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D1056491
LAB Type Physician Office
Facility Name CAROLINA PHYSICIANS GROUP PC
Street 7615 COLONY RD STE 115
City CHARLOTTE
State NC
ZIP 28226
Phone 704 626-6812
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Physician Office
Lab Director JAY FERNANDO

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