34D1089193 CLIA NUMBER - SUMMIT PLACE OF SOUTH PARK

Laboratory Demographics

  • CLIA Code: 34D1089193
  • Facility Name: SUMMIT PLACE OF SOUTH PARK
  • Facility Address: 2101 RUNNYMEDE LANE
    CHARLOTTE, NC
    ZIP 28209
  • Facility Phone: 704 525-5508
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CAMILLA J. CARPENTER- SHERRILL
  • NPI Number: 1730477399
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D1089193
LAB Type Assisted Living Facility
Facility Name SUMMIT PLACE OF SOUTH PARK
Street 2101 RUNNYMEDE LANE
City CHARLOTTE
State NC
ZIP 28209
Phone 704 525-5508
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Assisted Living Facility
Lab Director CAMILLA J. CARPENTER- SHERRILL

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