34D1096198 CLIA NUMBER - INTERNAL MEDICINE AND WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 34D1096198
  • Facility Name: INTERNAL MEDICINE AND WELLNESS CENTER
  • Facility Address: 10320 MALLARD CREEK RD STE 271
    CHARLOTTE, NC
    ZIP 28262
  • Facility Phone: 704 503-1332
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID S. MOSS
  • NPI Number: 1952543613
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D1096198
LAB Type Physician Office
Facility Name INTERNAL MEDICINE AND WELLNESS CENTER
Street 10320 MALLARD CREEK RD STE 271
City CHARLOTTE
State NC
ZIP 28262
Phone 704 503-1332
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 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director DAVID S. MOSS

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