34D1075062 CLIA NUMBER - NORTHLAKE NEPHROLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 34D1075062
  • Facility Name: NORTHLAKE NEPHROLOGY, PLLC
  • Facility Address: 1665 DAVIE AVENUE
    STATESVILLE, NC
    ZIP 28677
  • Facility Phone: 704 978-0052
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SINASI SALMAN
  • NPI Number: 1174548028
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D1075062
LAB Type Physician Office
Facility Name NORTHLAKE NEPHROLOGY, PLLC
Street 1665 DAVIE AVENUE
City STATESVILLE
State NC
ZIP 28677
Phone 704 978-0052
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 10/12/2023
Certificate Expiration Date 10/11/2025
Facility Type Physician Office
Lab Director SINASI SALMAN

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